Individual provider Active NPI

Quenlyn J. Larson, C.N.P. DNP

  • Pediatric Nurse Practitioner
  • Folsom, CA
National Provider Identifier
1518050897
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
NP 19804 Issued in CA
Practice address
1580 Creekside Dr Ste 200
Folsom, CA 95630-3888
Phone
(916) 924-9337
NPI assigned
Oct 1, 2006
Last updated
Feb 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN-187859 OH
Pediatric Nurse Practitioner 363LP0200X NP 19804 CA Primary

Addresses

Primary practice location

1580 Creekside Dr Ste 200
Folsom, CA 95630-3888

Mailing address

5841 Jameson CT
Carmichael, CA 95608-0895
Phone (916) 485-9800

Other practice location 1

1580 Creekside Dr Ste 250
Folsom, CA 95630-3889
Phone (916) 983-8595

Other practice location 2

550 E Romie Lane
Suite K
Salinas, CA 93901-4072
Phone (831) 422-9066

Other identifiers 1

IdentifierTypeStateIssuer
2350254MedicaidOH

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19804CAMDPhysical Therapist
NP 19804CAMDPediatric Nurse Practitioner
RN-187859OHMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Medical Associates of Sacramento Inc Past Accepting new patients

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": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1518050897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 JAMESON CT",
            "city": "CARMICHAEL",
            "state": "CA",
            "postal_code": "956080895",
            "telephone_number": "916-485-9800",
            "fax_number": "916-485-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1580 CREEKSIDE DR STE 200",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303888",
            "telephone_number": "916-924-9337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1580 Creekside Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956303889",
            "country_code": "US",
            "telephone_number": "916-983-8595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "550 E Romie Lane",
            "address_2": "Suite K",
            "address_purpose": "LOCATION",
            "city": "Salinas",
            "state": "CA",
            "postal_code": "939014072",
            "country_code": "US",
            "telephone_number": "831-422-9066",
            "fax_number": "831-422-4312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LARSON",
        "first_name": "QUENLYN",
        "middle_name": "J.",
        "credential": "C.N.P. DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "OH",
            "license": "RN-187859",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "NP 19804",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2350254",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; 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.