Provider Demographics
NPI:1295801470
Name:QUINN, ERIN C (NPF)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:C
Last Name:QUINN
Suffix:
Gender:F
Credentials:NPF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 THUNDER DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92083-6010
Mailing Address - Country:US
Mailing Address - Phone:760-941-1440
Mailing Address - Fax:760-941-1584
Practice Address - Street 1:145 THUNDER DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92083-6010
Practice Address - Country:US
Practice Address - Phone:760-941-1440
Practice Address - Fax:760-941-1584
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6812363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWG338169Medicare PIN
CA00NPF6812OtherBLUE CROSS BLUE SHIELD