Individual provider Active NPI

Anita Quiroz, PNP

  • Pediatric Nurse Practitioner
  • Stockton, CA
National Provider Identifier
1639295660
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN293195 Issued in CA
Practice address
89 W March LN
Suite #1
Stockton, CA 95207-5721
Phone
(209) 478-2622
Fax
(209) 870-2754
NPI assigned
Mar 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN293195 CA Primary

Addresses

Primary practice location

89 W March LN
Suite #1
Stockton, CA 95207-5721

Mailing address

89 W March LN
Suite #1
Stockton, CA 95207-5721
Phone (209) 478-2622

Other identifiers 2

IdentifierTypeStateIssuer
NP4332OtherCAFURNISHING NUMBER
RN293195OtherCARN LICENSE NUMBER

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
RN293195CAMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1639295660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 W MARCH LN",
            "address_2": "SUITE #1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075721",
            "telephone_number": "209-478-2622",
            "fax_number": "209-870-2754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 W MARCH LN",
            "address_2": "SUITE #1",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952075721",
            "telephone_number": "209-478-2622",
            "fax_number": "209-870-2754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIROZ",
        "first_name": "ANITA",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-21",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "RN293195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FURNISHING NUMBER",
            "identifier": "NP4332",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE NUMBER",
            "identifier": "RN293195",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.