Provider Demographics
NPI:1932967270
Name:QUIAMAS, SHANELLE FAE ALBANO
Entity Type:Individual
Prefix:
First Name:SHANELLE FAE
Middle Name:ALBANO
Last Name:QUIAMAS
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 1:9514 SUNGLOW CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-5764
Mailing Address - Country:US
Mailing Address - Phone:909-921-6309
Mailing Address - Fax:
Practice Address - Street 1:9514 SUNGLOW CT
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-5764
Practice Address - Country:US
Practice Address - Phone:909-921-6309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst