Individual provider Active NPI

Santiago Zeppelin Quintana

  • Behavior Technician
  • Albuquerque, NM
National Provider Identifier
1689401747
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
519022575 Issued in NM
Practice address
405 Judith LN SW
Albuquerque, NM 87121-2238
Phone
(505) 569-4592
NPI assigned
Sep 13, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X 519022575 NM Primary

Addresses

Primary practice location

405 Judith LN SW
Albuquerque, NM 87121-2238

Mailing address

405 Judith LN SW
Albuquerque, NM 87121-2238
Phone (505) 569-4592

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
519022575NMMDBehavior Technician

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1689401747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 JUDITH LN SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871212238",
            "telephone_number": "505-569-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 JUDITH LN SW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871212238",
            "telephone_number": "505-569-4592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTANA",
        "first_name": "SANTIAGO",
        "middle_name": "ZEPPELIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "NM",
            "license": "519022575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; 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.