Basic Information
Provider Information
NPI: 1578756862
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DELUNA
FirstName: QUINN
MiddleName: ANTHONY
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1201 N CALIFORNIA ST UNIT 30
Address2:  
City: ORANGE
State: CA
PostalCode: 928675000
CountryCode: US
TelephoneNumber: 7147420882
FaxNumber:  
Practice Location
Address1: 4129 STATE ST
Address2:  
City: SANTA BARBARA
State: CA
PostalCode: 931101848
CountryCode: US
TelephoneNumber: 8059644795
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/21/2007
LastUpdateDate: 08/21/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YA0400X  Y Behavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)

No ID Information.


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