Individual provider Active NPI

Miesha Quinones

  • Case Manager/Care Coordinator
  • Altadena, CA
National Provider Identifier
1245574904
Registry record updated Nov 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
760 Mountain View St
Altadena, CA 91001-4925
Phone
(626) 798-6793
NPI assigned
Nov 19, 2012
Last updated
Nov 19, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU Primary

Addresses

Primary practice location

760 Mountain View St
Altadena, CA 91001-4925

Mailing address

760 Mountain View St
Altadena, CA 91001-4925
Phone (626) 798-6793

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
I20240706000445 CA Practitioner - Marriage and Family Therapist 9133663768 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Change Within Reach IncGroup PAC ID 2062723810, 13 clinicians

Practice addresses (Care Compare)

17777 Ventura Blvd
Suite 105
Encino, CA 91316-3738
Phone (213) 908-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106290CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Change Within Reach Inc CurrentSince Jun 1, 2024 Accepting new patients

Locations

17777 Ventura Blvd
Ste 105
Encino, CA 91316
Phone (213) 445-2266

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1353283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353283200000",
    "number": "1245574904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 MOUNTAIN VIEW ST",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910014925",
            "telephone_number": "626-798-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 MOUNTAIN VIEW ST",
            "city": "ALTADENA",
            "state": "CA",
            "postal_code": "910014925",
            "telephone_number": "626-798-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "MIESHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-19",
        "last_updated": "2012-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altadena, CA

Sources for this page

Verify at the official NPI Registry.