Provider Demographics
NPI:1336822899
Name:QUITORIANO, JENALYN CUNANAN
Entity Type:Individual
Prefix:
First Name:JENALYN
Middle Name:CUNANAN
Last Name:QUITORIANO
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 1:13160 MACDILL CT
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79908-3012
Mailing Address - Country:US
Mailing Address - Phone:209-407-7304
Mailing Address - Fax:
Practice Address - Street 1:1625 HAWKINS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1201
Practice Address - Country:US
Practice Address - Phone:915-320-4710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-10
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician