Jeremy Queruel Moreno

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

1510 Argonaut Rd
Lakeport, CA 95453-9361

Phone

(707) 263-5819

NPI assigned

Feb 29, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Lake County Office of Education

  • Local Education Agency (LEA)
  • Lakeport, CA
  • NPI 1649609926
  NPD (past)

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

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1275390882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19755 MOUNTAIN MDW N",
            "city": "HIDDEN VALLEY LAKE",
            "state": "CA",
            "postal_code": "954678544",
            "telephone_number": "714-925-0528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 ARGONAUT RD",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954539361",
            "telephone_number": "707-263-5819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "JEREMY",
        "middle_name": "QUERUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Joseph Mitchell, PTA
• Suzanne Moineau, LMFT
• Robert A Montgomery
• Tiffany Montiel
• Xochilt Josefina Morales de Martinez, MFTI
• Morfin, O.D., Optometric Corporation
• Carol Morgan
• Kathryn Morgan, CMP
• Roxanne Morris
• Moutaz Almawaldi MD PC

• Case Manager/Care Coordinator in Lakeport, CA
• Providers in Lakeport, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.