Provider Demographics
NPI:1134260425
Name:QUINN, KATHLEEN J (LCSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:J
Last Name:QUINN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:
Other - Last Name:PHILHOUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:611 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:PARADISE
Mailing Address - State:CA
Mailing Address - Zip Code:95969-3026
Mailing Address - Country:US
Mailing Address - Phone:530-327-8620
Mailing Address - Fax:
Practice Address - Street 1:757 FIR ST
Practice Address - Street 2:
Practice Address - City:PARADISE
Practice Address - State:CA
Practice Address - Zip Code:95969-4532
Practice Address - Country:US
Practice Address - Phone:530-327-8620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS137221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical