Provider Demographics
NPI:1881728525
Name:QUINTILIANI, TOBI (MA)
Entity type:Individual
Prefix:MRS
First Name:TOBI
Middle Name:
Last Name:QUINTILIANI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30817 VIA RIVERA
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-5342
Mailing Address - Country:US
Mailing Address - Phone:310-678-0483
Mailing Address - Fax:310-544-3026
Practice Address - Street 1:21707 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-7009
Practice Address - Country:US
Practice Address - Phone:310-543-9900
Practice Address - Fax:310-540-9910
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA48926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health