Provider Demographics
NPI:1174131197
Name:QUIGLEY, WENDY J (BCABA)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:J
Last Name:QUIGLEY
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 CHINQUAPIN AVE APT C6
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-3530
Mailing Address - Country:US
Mailing Address - Phone:760-586-3644
Mailing Address - Fax:
Practice Address - Street 1:1000 CHINQUAPIN AVE APT C6
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-3530
Practice Address - Country:US
Practice Address - Phone:760-586-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-15
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-22-61137103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst