Active NPI
Patrick Quick
- Community Health Worker
- Victorville, CA
National Provider Identifier
1962238865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Worker
- License
- C15BF-07-08-E-24-021
- Practice address
- 15497 W Sand St
Victorville, CA 92392-2910 - Phone
- (442) 327-9311
- NPI assigned
- Sep 9, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | C15BF-07-08-E-24-021 | CA | Primary |
Addresses
Primary practice location
15497 W Sand St
Victorville, CA 92392-2910
Mailing address
15497 W Sand St
Victorville, CA 92392-2910
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C15BF-07-08-E-24-021 | CA | MD | Community Health Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1725840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725840000000",
"number": "1962238865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15497 W SAND ST",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923922910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15497 W SAND ST",
"city": "VICTORVILLE",
"state": "CA",
"postal_code": "923922910",
"telephone_number": "442-327-9311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "QUICK",
"first_name": "PATRICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2024-09-09",
"last_updated": "2024-09-09",
"certification_date": "2024-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Community Health Worker",
"state": "CA",
"license": "C15BF-07-08-E-24-021",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victorville, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.