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Individual
JOSE LUIS QUIROGA
Active
Individual
JOSE LUIS QUIROGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY17172
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659315430
LEGAL ENTITY NPI#
CA
01
—
PSY17172
CLINICAL PSYCHOLOGIST
CA
01
—
ZZZ91891Z
MEDICARE GROUP ID#
CA
01
—
ZZZ91892Z
MEDICARE GROUP ID#
CA
01
—
ZZZ92069Z
MEDICARE GROUP ID#
CA
01
—
ZZZ92073Z
MEDICARE GROUP ID#
CA
Enumeration date
06/15/2006
Last updated
03/11/2008
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