Provider Demographics
NPI:1841968518
Name:QUAGLIERINI, DIMITRI ARMANO
Entity type:Individual
Prefix:MR
First Name:DIMITRI
Middle Name:ARMANO
Last Name:QUAGLIERINI
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 1:13 WILDBROOK
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-5451
Mailing Address - Country:US
Mailing Address - Phone:949-293-9099
Mailing Address - Fax:
Practice Address - Street 1:14751 PLAZA DR STE F
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2773
Practice Address - Country:US
Practice Address - Phone:949-293-9099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-30
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA142250106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist