Provider Demographics
NPI:1255176996
Name:QUINN-PERRY, CYBELE M
Entity type:Individual
Prefix:MS
First Name:CYBELE
Middle Name:M
Last Name:QUINN-PERRY
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 1:28877 PLAZA DE ORO
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-3033
Mailing Address - Country:US
Mailing Address - Phone:661-373-5221
Mailing Address - Fax:
Practice Address - Street 1:11565 LAUREL CANYON BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-4649
Practice Address - Country:US
Practice Address - Phone:661-373-5221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146063106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist