Individual provider Active NPI

Camden Quevedo, HIS

  • Hearing Instrument Specialist
  • Victorville, CA
National Provider Identifier
1669926523
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hearing Instrument SpecialistTaxonomy code 237700000X
License
HA8097 Issued in CA
Practice address
12637 Hesperia Rd Ste B
Victorville, CA 92395-7774
Phone
(760) 241-2250
Fax
(760) 241-2250
NPI assigned
Aug 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hearing Instrument Specialist 237700000X HA8097 CA Primary

Addresses

Primary practice location

12637 Hesperia Rd Ste B
Victorville, CA 92395-7774

Mailing address

750 N Commons Dr Ste 200
Aurora, IL 60504-7940
Phone (630) 303-5380

Other practice location 1

41789 Nicole Ln
Ste B2
Temecula, CA 92591-3871
Phone (951) 699-0111

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
HA8097CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Connect Hearing, Inc. Hearing Instrument Specialist CurrentSince May 10, 2020 Accepting new patients
Connect Hearing Inc Hearing Instrument Specialist PastSince Apr 5, 2020 Accepting new patients

Locations

12637 Hesperia Rd
Ste B
Victorville, CA 92395
Phone (760) 241-2250

750 N Commons Dr
Ste 200
Aurora, IL 60504

215 Shuman Blvd
Ste 401
Naperville, IL 60563
Phone (331) 229-8279

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1669926523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N COMMONS DR STE 200",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605047940",
            "telephone_number": "630-303-5380",
            "fax_number": "630-303-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12637 HESPERIA RD STE B",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923957774",
            "telephone_number": "760-241-2250",
            "fax_number": "760-241-2250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41789 Nicole Ln",
            "address_2": "Ste B2",
            "address_purpose": "LOCATION",
            "city": "Temecula",
            "state": "CA",
            "postal_code": "925913871",
            "country_code": "US",
            "telephone_number": "951-699-0111",
            "fax_number": "951-699-0444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEVEDO",
        "first_name": "CAMDEN",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-09",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "CA",
            "license": "HA8097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Victorville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.