Provider Demographics
NPI:1659690931
Name:QUIN, AIMEE WELLS (DACM, LAC)
Entity Type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:WELLS
Last Name:QUIN
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:MS
Other - First Name:AIMEE
Other - Middle Name:
Other - Last Name:WELLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DACM, LAC
Mailing Address - Street 1:823 GREENBERRY LN
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903-1225
Mailing Address - Country:US
Mailing Address - Phone:415-761-1969
Mailing Address - Fax:
Practice Address - Street 1:2831 7TH ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2702
Practice Address - Country:US
Practice Address - Phone:415-761-1969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA12559171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist