Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist |
NPI | 1023339157 |
---|---|
Provider Name | James De Quinto |
First Address | Santa Clara, CA 95051-6803 |
Second Address | Oakland, CA 94618-1033 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2010 |
Last Update Date | 11/06/2010 |