Individual provider Active NPI

Carolyn Rae Peters, MA, ATC, CSCS

  • Athletic Trainer
  • San Diego, CA
National Provider Identifier
1033184064
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
5505 Campanile Dr.
Aac 1402
San Diego, CA 92182-4313
Phone
(619) 594-7660
Fax
(619) 594-7654
NPI assigned
Feb 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X CA Primary

Addresses

Primary practice location

5505 Campanile Dr.
Aac 1402
San Diego, CA 92182-4313

Mailing address

5742 Hughes St
San Diego, CA 92115-6513
Phone (619) 594-7660

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
Credentials
Master of Arts

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1033184064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5742 HUGHES ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921156513",
            "telephone_number": "619-594-7660",
            "fax_number": "619-594-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5505 CAMPANILE DR.",
            "address_2": "AAC 1402",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921824313",
            "telephone_number": "619-594-7660",
            "fax_number": "619-594-7654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "CAROLYN",
        "middle_name": "RAE",
        "credential": "MA, ATC, CSCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.