Individual provider Active NPI

Emiliano Dandan Baquir Jr., PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Valencia, CA
National Provider Identifier
1861951352
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
NP95010889 Issued in CA
Practice address
25000 Avenue Stanford Ste 167
Valencia, CA 91355-4596
Phone
(818) 600-2034
Fax
(661) 667-4477
NPI assigned
Mar 14, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NP95010889 CA Primary

Addresses

Primary practice location

25000 Avenue Stanford Ste 167
Valencia, CA 91355-4596

Mailing address

2018 Jolley Dr
Burbank, CA 91504-2946
Phone (818) 915-3404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200507000383 CA Practitioner - Nurse Practitioner 7810328820 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
New U Therapy Center and Family Services IncGroup PAC ID 4981034402, 20 clinicians
William Gillespie and Associates IncGroup PAC ID 7517181373, 16 clinicians

Practice addresses (Care Compare)

25000 Ave Stanford
Suite 167
Valencia, CA 91355-4596
Phone (818) 600-2034

510 S Grand Ave
Suite 200
Glendora, CA 91741-4291
Phone (626) 914-1980

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NP95010889CAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
William Gillespie and Associates Inc. CurrentSince Sep 8, 2021 Accepting new patients
New U Therapy Center & Family Services Inc. Psychiatric/Mental Health CurrentSince Mar 1, 2020 Accepting new patients

Locations

510 S Grand Ave
Ste 200
Glendora, CA 91741
Phone (626) 914-1980

1626 Montana Ave
Ste 645
Santa Monica, CA 90403

21615 Hawthorne Blvd
Ste 200
Torrance, CA 90503
Phone (310) 371-8555

3812 Sepulveda Blvd
Ste 260
Torrance, CA 90505
Phone (661) 535-0916

25000 Avenue Stanford
Ste 167
Valencia, CA 91355
Phone (661) 299-7033

31200 Via Colinas
Ste 202
Westlake Village, CA 91362
Phone (661) 299-7033

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": "1552521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1861951352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2018 JOLLEY DR",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915042946",
            "telephone_number": "818-915-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25000 AVENUE STANFORD STE 167",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554596",
            "telephone_number": "818-600-2034",
            "fax_number": "661-667-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAQUIR",
        "first_name": "EMILIANO",
        "middle_name": "DANDAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-14",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "NP95010889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.