Individual
JESUS QUIRARTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
255 TERRACINA BLVD, REDLANDS, CA 92373-4870
(909) 798-1763
Mailing address
255 TERRACINA BLVD STE 204, REDLANDS, CA 92373-4870
(909) 798-1763
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
829189
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2019060742
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124100383
—
CA
Enumeration date
02/20/2013
Last updated
02/22/2021
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