Provider Demographics
NPI:1841588191
Name:SINGLETON, QUINCY SR (LMFT 88212)
Entity Type:Individual
Prefix:
First Name:QUINCY
Middle Name:
Last Name:SINGLETON
Suffix:SR
Gender:M
Credentials:LMFT 88212
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20100 S WESTERN AVE # A4
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-1307
Mailing Address - Country:US
Mailing Address - Phone:626-394-8087
Mailing Address - Fax:
Practice Address - Street 1:20100 S WESTERN AVE # A4
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90501-1307
Practice Address - Country:US
Practice Address - Phone:626-394-8087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-20
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 88212106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95-2633765OtherMEDI-CAL