Provider Demographics
NPI:1710208103
Name:QUITORIANO, DARLENE CLAUD (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:DARLENE
Middle Name:CLAUD
Last Name:QUITORIANO
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2182 FAIRMONT CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-1709
Mailing Address - Country:US
Mailing Address - Phone:323-472-0685
Mailing Address - Fax:
Practice Address - Street 1:1041 HILL ST
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:CA
Practice Address - Zip Code:94002-2317
Practice Address - Country:US
Practice Address - Phone:323-472-0685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-20
Last Update Date:2010-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8421225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
A# 086-946-157OtherPERMANENT RESIDENT CARD