Individual provider Active NPI

Julie Ann Quakenbush, M.D.

  • Internal Medicine Physician
  • Los Gatos, CA
National Provider Identifier
1164441267
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G061774 Issued in CA
Practice address
360 Dardanelli LN
Suite 2E
Los Gatos, CA 95032-1421
Phone
(408) 378-1101
Fax
(408) 378-1039
NPI assigned
Jul 19, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G061774 CA Primary

Addresses

Primary practice location

360 Dardanelli LN
Suite 2E
Los Gatos, CA 95032-1421

Mailing address

360 Dardanelli LN
Suite 2E
Los Gatos, CA 95032-1421
Phone (408) 378-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G061774CAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164441267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 DARDANELLI LN",
            "address_2": "SUITE 2E",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321421",
            "telephone_number": "408-378-1101",
            "fax_number": "408-378-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 DARDANELLI LN",
            "address_2": "SUITE 2E",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321421",
            "telephone_number": "408-378-1101",
            "fax_number": "408-378-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAKENBUSH",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G061774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.