Individual
CARLOS DANIEL QUINTANILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
30 PROFESSIONAL CENTER PKWY, SAN RAFAEL, CA 94903-2757
(707) 495-2938
Mailing address
1019 TRENTON BLVD, SAN PABLO, CA 94806-2895
(510) 260-3794
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
—
—
225400000X
Rehabilitation Practitioner
—
—
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
02/13/2023
Last updated
05/30/2025
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