Provider Demographics
NPI:1790240026
Name:QUINTERO, ROSENDA MARIE (PFA)
Entity Type:Individual
Prefix:MISS
First Name:ROSENDA
Middle Name:MARIE
Last Name:QUINTERO
Suffix:
Gender:F
Credentials:PFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7281 DUMOSA AVNEUE
Mailing Address - Street 2:STE 4
Mailing Address - City:YUCCA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92284
Mailing Address - Country:US
Mailing Address - Phone:760-853-4755
Mailing Address - Fax:760-513-9717
Practice Address - Street 1:7281 DUMOSA AVNEUE
Practice Address - Street 2:STE 4
Practice Address - City:YUCCA VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92284
Practice Address - Country:US
Practice Address - Phone:760-853-4755
Practice Address - Fax:760-513-9717
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator