Individual provider Active NPI

Fernando Rodriguez Quiroz Jr.

  • Behavior Analyst
  • Lake Forest, CA
National Provider Identifier
1780166165
Registry record updated Sep 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
Y3448703 Issued in CA
Practice address
25601 Heatherow Cir
Lake Forest, CA 92630-5020
Phone
(949) 891-5020
NPI assigned
Sep 3, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Y3448703 CA Primary

Addresses

Primary practice location

25601 Heatherow Cir
Lake Forest, CA 92630-5020

Mailing address

25601 Heatherow Cir
Lake Forest, CA 92630-5020
Phone (949) 891-5020

Other practice location 1

25601 Heatherow Cir
Lake Forest, CA 92630-5020
Phone (949) 891-5020

Other practice location 2

25601 Heatherow Cir
Lake Forest, CA 92630-5020
Phone (949) 891-5020

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
Y3448703CAMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535932800000",
    "number": "1780166165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25601 HEATHEROW CIR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305020",
            "telephone_number": "949-891-5020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25601 HEATHEROW CIR",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926305020",
            "telephone_number": "949-891-5020"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25601 Heatherow Cir",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "CA",
            "postal_code": "926305020",
            "country_code": "US",
            "telephone_number": "949-891-5020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25601 Heatherow Cir",
            "address_purpose": "LOCATION",
            "city": "Lake Forest",
            "state": "CA",
            "postal_code": "926305020",
            "country_code": "US",
            "telephone_number": "949-891-5020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUIROZ",
        "first_name": "FERNANDO",
        "middle_name": "RODRIGUEZ",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-03",
        "last_updated": "2018-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "Y3448703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Forest, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2018; 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.