Blanca A. Quevedo

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

License

104194 Issued in CA

Practice address

4701 E Cesar Chavez Ave
East Los Angeles, CA 90022

Phone

(213) 364-1325

NPI assigned

Sep 7, 2007

Last updated

May 13, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747094400000",
    "number": "1548455108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3258 E 3RD ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900633014",
            "telephone_number": "323-719-0535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 E CESAR CHAVEZ AVE",
            "city": "EAST LOS ANGELES",
            "state": "CA",
            "postal_code": "90022",
            "telephone_number": "213-364-1325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 S Vermont Ave Fl 6",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900201912",
            "country_code": "US",
            "telephone_number": "213-364-1325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEVEDO",
        "first_name": "BLANCA",
        "middle_name": "A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "68122",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "104194",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Nguyen, D.D.S.
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• Julia Park
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• Ana Posada
• Sergio Quirarte
• Adam Abraham Radwan
• Heliberto Ramos Gonzalez, MSW
• Sergio Ramos
• Erica Estela Regalado, LVN

• Rehabilitation Practitioner in East Los Angeles, CA
• Providers in East Los Angeles, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.