Individual provider Active NPI

Suzanne M. Quijano, MA, LMFT

  • Marriage & Family Therapist
  • Davis, CA
National Provider Identifier
1902123524
Registry record updated Mar 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
100027 Issued in CA
Practice address
1520 E Covell Blvd # B5-206
Davis, CA 95616-1366
Phone
(510) 333-7106
NPI assigned
Apr 21, 2010
Last updated
Mar 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 100027 CA Primary

Addresses

Primary practice location

1520 E Covell Blvd # B5-206
Davis, CA 95616-1366

Mailing address

1520 E Covell Blvd # B5-206
Davis, CA 95616-1366
Phone (510) 333-7106

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 19, 2024 through Jan 19, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
100027CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1902123524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 E COVELL BLVD # B5-206",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956161366",
            "telephone_number": "510-333-7106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 E COVELL BLVD # B5-206",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956161366",
            "telephone_number": "510-333-7106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIJANO",
        "first_name": "SUZANNE",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "MA, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-21",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100027",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.