Provider Demographics
NPI:1487869822
Name:QUINN, MAURA M (MFC 32971)
Entity type:Individual
Prefix:MS
First Name:MAURA
Middle Name:M
Last Name:QUINN
Suffix:
Gender:F
Credentials:MFC 32971
Other - Prefix:
Other - First Name:MAURA
Other - Middle Name:M
Other - Last Name:QUINN BRISENO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1965 LIVE OAK BLVD
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991
Mailing Address - Country:US
Mailing Address - Phone:530-822-7209
Mailing Address - Fax:530-822-7294
Practice Address - Street 1:1965 LIVE OAK BLVD
Practice Address - Street 2:SUTLER YUBA MENTAL HEALTH
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991
Practice Address - Country:US
Practice Address - Phone:530-822-7209
Practice Address - Fax:530-822-7294
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32971106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist