Provider Demographics
NPI:1316322381
Name:QUINN, TIMOTHY JOSEPH JR (LMFT)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JOSEPH
Last Name:QUINN
Suffix:JR
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2042 BELLAMY ST
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95354-2907
Mailing Address - Country:US
Mailing Address - Phone:209-988-3031
Mailing Address - Fax:
Practice Address - Street 1:2042 BELLAMY ST
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95354-2907
Practice Address - Country:US
Practice Address - Phone:209-988-3031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111519106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist