Quincy Kenoly

Key facts

NPI

1831989474

Entity type

Individual (NPI type 1)

Primary specialty

Day Training/Habilitation Specialist 373H00000X

Practice address

130 W Flora St
Stockton, CA 95202-1636

Phone

(209) 319-6036

NPI assigned

May 7, 2025

Sex

Male

Sole proprietor

Yes

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on May 7, 2025.

{
    "created_epoch": "1746576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1831989474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W FLORA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021636",
            "telephone_number": "209-319-6036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W FLORA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021636",
            "telephone_number": "209-319-6036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENOLY",
        "first_name": "QUINCY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-07",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "373H00000X",
            "taxonomy_group": "",
            "desc": "Day Training/Habilitation Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

• Jennifer Marie Kennalley
• Amanda Kennedy
• Carla Respondo Kennedy, CATCI
• Kenneth V. Miselis, M.D. Inc.
• Bobbie Jean Kenoly
• Jolene S Keo
• Linda Keo
• Lousinda M Keo
• Dianne Keokham, PHARMD
• Jezabelle Keopadubsy

All providers in Stockton, CA · Day Training/Habilitation Specialist in California