Provider Demographics
NPI:1184773046
Name:QUINTEROS, ABRAHAM (LVN)
Entity type:Individual
Prefix:MR
First Name:ABRAHAM
Middle Name:
Last Name:QUINTEROS
Suffix:
Gender:M
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 E DE LA GUERRA ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93103-3009
Mailing Address - Country:US
Mailing Address - Phone:805-965-7387
Mailing Address - Fax:
Practice Address - Street 1:5700 RALSTON ST
Practice Address - Street 2:STE 312
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6050
Practice Address - Country:US
Practice Address - Phone:805-642-7033
Practice Address - Fax:805-642-7732
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN216090164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse