Active NPI
Suzanne M. Quijano, MA, LMFT
- Marriage & Family Therapist
- Davis, CA
National Provider Identifier
1902123524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 100027
- 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, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 100027 | CA | MD | Marriage & 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.