Provider Demographics
NPI:1306672852
Name:QUADRA, ROBERTO W
Entity type:Individual
Prefix:
First Name:ROBERTO
Middle Name:W
Last Name:QUADRA
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 CRESCENT WAY APT 5209
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-3339
Mailing Address - Country:US
Mailing Address - Phone:415-806-1994
Mailing Address - Fax:
Practice Address - Street 1:13925 SAN PABLO AVE STE 201
Practice Address - Street 2:
Practice Address - City:SAN PABLO
Practice Address - State:CA
Practice Address - Zip Code:94806-3676
Practice Address - Country:US
Practice Address - Phone:510-525-6225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-11
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program