Provider Demographics
NPI:1386663045
Name:QUINONES, JOHN M (MA, MFT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:M
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 COFFEE RD STE F145
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95355-2050
Mailing Address - Country:US
Mailing Address - Phone:209-499-4251
Mailing Address - Fax:
Practice Address - Street 1:2625 COFFEE RD STE F145
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2050
Practice Address - Country:US
Practice Address - Phone:209-499-4251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 39542106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist