Active NPI
Angel Albert Quintanilla, ACSW
- Clinical Social Worker
- Van Nuys, CA
National Provider Identifier
1780980771
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 102690
- Practice address
- 7515 Van Nuys Blvd
Van Nuys, CA 91405-1949 - Phone
- (818) 627-3445
- NPI assigned
- Feb 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | CA | ||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 102690 | CA | Primary |
Addresses
Primary practice location
7515 Van Nuys Blvd
Van Nuys, CA 91405-1949
Mailing address
7515 Van Nuys Blvd
Van Nuys, CA 91405-1949
Phone (818) 627-3424
Other practice location 1
7555 Van Nuys Blvd.,
Van Nuys, CA 91405-1949
Phone (818) 627-3424
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
| License | State | Type | Specialty |
|---|---|---|---|
| 102690 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687305600000",
"number": "1780980771",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7515 VAN NUYS BLVD",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914051949",
"telephone_number": "818-627-3424",
"fax_number": "818-947-4070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7515 VAN NUYS BLVD",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914051949",
"telephone_number": "818-627-3445"
}
],
"practiceLocations": [
{
"address_1": "7555 Van Nuys Blvd.,",
"address_purpose": "LOCATION",
"city": "Van Nuys",
"state": "CA",
"postal_code": "914051949",
"country_code": "US",
"telephone_number": "818-627-3424",
"fax_number": "818-947-4070",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "QUINTANILLA",
"first_name": "ANGEL",
"middle_name": "ALBERT",
"name_prefix": "Mr.",
"credential": "ACSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-08",
"last_updated": "2023-06-21",
"certification_date": "2023-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "102690",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.