Individual provider Active NPI

David Jose Quinteros, MSW

  • Clinical Social Worker
  • Covina, CA
National Provider Identifier
1457669384
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
74438 Issued in CA
Practice address
1126 N Grand Ave Ste D
Covina, CA 91724-1552
Phone
(909) 967-1667
NPI assigned
Sep 14, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 74438 CA Primary

Addresses

Primary practice location

1126 N Grand Ave Ste D
Covina, CA 91724-1552

Mailing address

1650 E Old Badillo St
# B3
Covina, CA 91724-3163
Phone (323) 313-4053

Other names 1

  • David Jose Madrid-Quinteros Former 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
I20161215000400 CA Practitioner - Clinical Social Worker 9032499785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Communities Healthcare DistrictGroup PAC ID 9133227135, shared by 4 NPIs, 34 clinicians

Practice addresses (Care Compare)

PO Box
Suite 1229
Weaverville, CA 96093-1229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
74438CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Masonic Homes of California CurrentSince Oct 1, 2020 Accepting new patients
Masonic Homes of California CurrentSince Oct 1, 2020 Accepting new patients
Masonic Homes of California Past Accepting new patients
Mountain Communities Healthcare Dist Past Accepting new patients

Locations

1650 E Old Badillo St
Covina, CA 91724
Phone (626) 251-2200

1650 E Old Badillo St
#B3
Covina, CA 91724
Phone (626) 251-2300

1111 California St
San Francisco, CA 94108

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1284422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1457669384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 E OLD BADILLO ST",
            "address_2": "# B3",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917243163",
            "telephone_number": "323-313-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1126 N GRAND AVE STE D",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917241552",
            "telephone_number": "909-967-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTEROS",
        "first_name": "DAVID",
        "middle_name": "JOSE",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-14",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "74438",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "MADRID-QUINTEROS",
            "middle_name": "JOSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Covina, CA

Sources for this page

Verify at the official NPI Registry.