Individual provider Active NPI

Andrew Quero, LVN

  • Licensed Practical Nurse
  • San Diego, CA
National Provider Identifier
1407503188
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
205023 Issued in CA
Practice address
4974 El Cajon Blvd Ste a
San Diego, CA 92115-4677
Phone
(619) 357-0758
NPI assigned
Mar 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 205023 CA Primary

Addresses

Primary practice location

4974 El Cajon Blvd Ste a
San Diego, CA 92115-4677

Mailing address

4974 El Cajon Blvd Ste a
San Diego, CA 92115-4677
Phone (619) 357-0758

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
205023CAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1646265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1407503188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4974 EL CAJON BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154677",
            "telephone_number": "619-357-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4974 EL CAJON BLVD STE A",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921154677",
            "telephone_number": "619-357-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUERO",
        "first_name": "ANDREW",
        "credential": "LVN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-03",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "CA",
            "license": "205023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2022; 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.