Provider Demographics
NPI:1437045358
Name:QUANTUM THERANOSTICS PROGRAM AND TREATMENT CENTER
Entity type:Organization
Organization Name:QUANTUM THERANOSTICS PROGRAM AND TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:CUESTA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:818-939-9190
Mailing Address - Street 1:36013 REDGRAVE WAY
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6609
Mailing Address - Country:US
Mailing Address - Phone:951-533-9404
Mailing Address - Fax:
Practice Address - Street 1:145 S CHAPARRAL CT STE 101
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92808-2265
Practice Address - Country:US
Practice Address - Phone:888-998-8463
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & TherapyGroup - Multi-Specialty