Provider Demographics
NPI:1871619429
Name:QUIRARTE, LAURA B
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:B
Last Name:QUIRARTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 LAYTON ST
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91104-1641
Mailing Address - Country:US
Mailing Address - Phone:818-755-4950
Mailing Address - Fax:
Practice Address - Street 1:10526 DUBNOFF WAY
Practice Address - Street 2:
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3921
Practice Address - Country:US
Practice Address - Phone:818-755-4950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator