Provider Demographics
NPI:1629390182
Name:QUESADA, MARIA DOLORES (QMHW)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:DOLORES
Last Name:QUESADA
Suffix:
Gender:F
Credentials:QMHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-5913
Mailing Address - Country:US
Mailing Address - Phone:805-740-4555
Mailing Address - Fax:805-740-4558
Practice Address - Street 1:120 W CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-5913
Practice Address - Country:US
Practice Address - Phone:805-740-4555
Practice Address - Fax:805-740-4558
Is Sole Proprietor?:No
Enumeration Date:2010-02-24
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator