Individual provider Active NPI

Catherine Melliza Garganera-Quinzon, MSN-FNP

  • Family Nurse Practitioner
  • Van Nuys, CA
National Provider Identifier
1902253792
Registry record updated Sep 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NP95004047 Issued in CA
Practice address
6544 Valjean Ave
Van Nuys, CA 91406-5824
Phone
(818) 667-3648
NPI assigned
May 21, 2016
Last updated
Sep 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NP95004047 CA Primary

Addresses

Primary practice location

6544 Valjean Ave
Van Nuys, CA 91406-5824

Mailing address

6544 Valjean Ave
Van Nuys, CA 91406-5824
Phone (818) 667-3648

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
I20170919004108 CA Practitioner - Nurse Practitioner 3779857404 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NP95004047CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Noninvasive Medical Imaging Incorporated CurrentSince Jun 18, 2019 Accepting new patients
Mid Valley Vascular Center, Inc CurrentSince Jun 18, 2019 Accepting new patients
Leo Polosajian MD a Professional Med Corp CurrentSince Jun 18, 2019 Accepting new patients

Locations

4930 Balboa Blvd
Unit 261278
Encino, CA 91426

7640 Tampa Ave
Ste 101
Reseda, CA 91335
Phone (818) 718-1600

7640 Tampa Ave
Ste 101A
Reseda, CA 91335
Phone (818) 718-1600

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1463788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473465600000",
    "number": "1902253792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6544 VALJEAN AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914065824",
            "telephone_number": "818-667-3648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6544 VALJEAN AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914065824",
            "telephone_number": "818-667-3648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARGANERA-QUINZON",
        "first_name": "CATHERINE",
        "middle_name": "MELLIZA",
        "credential": "MSN-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-21",
        "last_updated": "2016-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95004047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

Verify at the official NPI Registry.