Provider Demographics
NPI:1760874366
Name:QUINONEZ, BRIDGETT XANTEE (NP)
Entity Type:Individual
Prefix:MS
First Name:BRIDGETT
Middle Name:XANTEE
Last Name:QUINONEZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12901 HEATHER CREST CT
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92503-7910
Mailing Address - Country:US
Mailing Address - Phone:213-718-1238
Mailing Address - Fax:
Practice Address - Street 1:12901 HEATHER CREST CT
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-7910
Practice Address - Country:US
Practice Address - Phone:213-718-1238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-19
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95001805363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily