Victoria Quevedo

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

6300 W Old Shakopee Rd
Bloomington, MN 55438-2654

Phone

(612) 261-1503

NPI assigned

May 11, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1568046068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12312 PARKWOOD DR APT 223",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553372946",
            "telephone_number": "612-483-0837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W OLD SHAKOPEE RD",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554382654",
            "telephone_number": "612-261-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUEVEDO",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06144898",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://caravelautism.com/contact-us/",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "6300 W Old Shakopee Rd",
            "city": "Bloomington",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554382654",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shafi Yusuf Qanyare
• Quality Care Services LLC
• Philip Richard Quamme
• Janet M Quarn, ANP
• Nancy Lee Quast
• Taylor Marie Quickstrom
• Travis Mark Quinlan, LICSW
• Jenna Hassanein Raad
• Najma Rabi
• Hannah Marie Rademacher

• Behavior Technician in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.