NPIMap

Organization Active NPI

Pepperdine University

  • Student Health Clinic/Center
  • Malibu, CA
National Provider Identifier
1043867971
Registry record updated Aug 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student Health Clinic/CenterTaxonomy code 261QS1000X
Legal business name
PEPPERDINE UNIVERSITY
Practice address
24255 Pacific Coast Hwy
Malibu, CA 90263-3999
Phone
(310) 506-4316
NPI assigned
Aug 26, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2019

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

Authorized official

Name
Nicole Mariko Elby, PT, DPT, SCS, ATC
Title
Rehabilitation Coordinator
Phone
(310) 506-4169

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student Health Clinic/Center 261QS1000X Primary

Addresses

Primary practice location

24255 Pacific Coast Hwy
Malibu, CA 90263-3999

Mailing address

24255 Pacific Coast Hwy
Malibu, CA 90263-3999
Phone (310) 506-4316

Other names 1

  • Student Health Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Pepperdine Community Counseling Center Encino3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1043867971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24255 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902633999",
            "telephone_number": "310-506-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24255 PACIFIC COAST HWY",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902633999",
            "telephone_number": "310-506-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEPPERDINE UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "ELBY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "MARIKO",
        "authorized_official_title_or_position": "REHABILITATION COORDINATOR",
        "authorized_official_telephone_number": "310-506-4169",
        "authorized_official_credential": "PT, DPT, SCS, ATC"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Student Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Malibu, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.