Provider Demographics
NPI:1639400310
Name:MC QUINN, ANNA MARIA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIA
Last Name:MC QUINN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 SAN CARLOS AVE
Mailing Address - Street 2:SUITEC
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070
Mailing Address - Country:US
Mailing Address - Phone:650-508-1942
Mailing Address - Fax:650-593-5902
Practice Address - Street 1:1395 SAN CARLOS AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-2388
Practice Address - Country:US
Practice Address - Phone:650-508-1942
Practice Address - Fax:650-593-5902
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12098103T00000X
CAMFT25684106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist