Provider Demographics
NPI:1972897288
Name:QUINTERO-GONZALEZ, BRENDA ZULEM
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:ZULEM
Last Name:QUINTERO-GONZALEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1067 BISON WAY
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93905-4449
Mailing Address - Country:US
Mailing Address - Phone:831-262-4209
Mailing Address - Fax:
Practice Address - Street 1:124 RIVER ROAD
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3122
Practice Address - Country:US
Practice Address - Phone:831-455-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-03
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program