Individual provider Active NPI

Kristin Quayle, L.C.S.W.

  • Clinical Social Worker
  • Sacramento, CA
National Provider Identifier
1558635540
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
25852 Issued in CA
Practice address
2221 Stockton Blvd
Cypress BLDG, Ste C
Sacramento, CA 95817-1418
Phone
(916) 734-5740
Fax
(916) 734-1339
NPI assigned
Mar 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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 25852 CA Primary

Addresses

Primary practice location

2221 Stockton Blvd
Cypress BLDG, Ste C
Sacramento, CA 95817-1418

Mailing address

4800 Moddison Ave
Sacramento, CA 95819-1500
Phone (916) 440-6655

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
25852CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331164800000",
    "number": "1558635540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 MODDISON AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958191500",
            "telephone_number": "916-440-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2221 STOCKTON BLVD",
            "address_2": "CYPRESS BLDG, STE C",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171418",
            "telephone_number": "916-734-5740",
            "fax_number": "916-734-1339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAYLE",
        "first_name": "KRISTIN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "25852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.