Individual provider Active NPI

Agnes Lenahan Quinn, PHD

  • Psychologist
  • San Francisco, CA
National Provider Identifier
1184740078
Registry record updated Dec 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
26600 Issued in CA
Practice address
45 Franklin St
Suite 211
San Francisco, CA 94102-6017
Phone
(415) 390-2608
Fax
(415) 390-2608
NPI assigned
Mar 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 26600 CA Primary

Addresses

Primary practice location

45 Franklin St
Suite 211
San Francisco, CA 94102-6017

Mailing address

45 Franklin St
Suite 211
San Francisco, CA 94102-6017
Phone (415) 390-2608

Other identifiers 2

IdentifierTypeStateIssuer
11264OtherSFGH INTERNAL USE ONLY
11264OtherCBHS INTERNAL USE ONLY-COMMERCIAL NUMBER

Other names 1

  • Dr. Aggie Lenahan Quinn Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150205002310 CA Practitioner - Clinical Psychologist 7517282924 Practice locations: San Francisco, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

295 Fell St
San Francisco, CA 94102-5147

295 Fell St a
San Francisco, CA 94102-5147
Phone (415) 390-2608

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26600CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417564800000",
    "number": "1184740078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 FRANKLIN ST",
            "address_2": "SUITE 211",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941026017",
            "telephone_number": "415-390-2608",
            "fax_number": "415-390-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 FRANKLIN ST",
            "address_2": "SUITE 211",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941026017",
            "telephone_number": "415-390-2608",
            "fax_number": "415-390-2608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "AGNES",
        "middle_name": "LENAHAN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-22",
        "last_updated": "2014-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "26600",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SFGH INTERNAL USE ONLY",
            "identifier": "11264",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CBHS INTERNAL USE ONLY-COMMERCIAL NUMBER",
            "identifier": "11264",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGGIE",
            "last_name": "QUINN",
            "middle_name": "LENAHAN",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.