Provider Demographics
NPI:1912032673
Name:CALDWELL, QUINN LORRAINE (AA)
Entity Type:Individual
Prefix:MRS
First Name:QUINN
Middle Name:LORRAINE
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:AA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4356 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-1413
Mailing Address - Country:US
Mailing Address - Phone:562-537-1703
Mailing Address - Fax:
Practice Address - Street 1:4356 CLARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1413
Practice Address - Country:US
Practice Address - Phone:562-537-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health