Provider Demographics
NPI:1689412504
Name:MCLAUGHLIN, QUINN WENDOLYN
Entity type:Individual
Prefix:
First Name:QUINN
Middle Name:WENDOLYN
Last Name:MCLAUGHLIN
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 1:1965 SHERINGTON PL APT K208
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92663-6086
Mailing Address - Country:US
Mailing Address - Phone:949-572-1071
Mailing Address - Fax:
Practice Address - Street 1:4000 BIRCH ST STE 112
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2255
Practice Address - Country:US
Practice Address - Phone:949-572-1071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA179236101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)