Samuel Jason Quinones

Key facts

NPI

1558021154

Entity type

Individual (NPI type 1)

Primary specialty

Case Manager/Care Coordinator 171M00000X

Practice address

11517 15TH Ave
Lemoore, CA 93245-9508

Phone

(559) 380-0800

NPI assigned

Dec 22, 2021

Sex

Male

Sole proprietor

No

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 and National Provider Directory roles.

• Champions Recovery Alternative Programs, Inc. Substance Abuse Rehabilitation Facility · Lemoore, CA · NPI 1255797155
  NPD

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 22, 2021.

{
    "created_epoch": "1640131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1558021154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2442 E BEECH AVE",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932921360",
            "telephone_number": "415-580-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11517 15TH AVE",
            "city": "LEMOORE",
            "state": "CA",
            "postal_code": "932459508",
            "telephone_number": "559-380-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINONES",
        "first_name": "SAMUEL",
        "middle_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-22",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Lemoore, CA · Case Manager/Care Coordinator in California