Individual
ANDREA YVONNE QUINTANA I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1901 CLEVELAND AVE STE B, SANTA ROSA, CA 95401-4298
(707) 576-0818
Mailing address
611 WILLRUSH ST, SANTA ROSA, CA 95401-5331
(707) 889-5450
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
31638
CA
Other
Enumeration date
11/03/2015
Last updated
11/03/2015
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