Provider Demographics
NPI:1518436526
Name:QUINTERO, JULIO D
Entity type:Individual
Prefix:
First Name:JULIO
Middle Name:D
Last Name:QUINTERO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 N BUSH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-3727
Mailing Address - Country:US
Mailing Address - Phone:714-975-4359
Mailing Address - Fax:
Practice Address - Street 1:18 TECHNOLOGY DR STE 206
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2314
Practice Address - Country:US
Practice Address - Phone:949-540-9151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0021501350OtherKAISER PERMANENTE