Active NPI
Kristin Munoz
- Athletic Trainer
- Redlands, CA
National Provider Identifier
1063092278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- PT0039268
- Practice address
- 1436 Industrial Park Ave Ste 11
Redlands, CA 92374-4517 - Phone
- (909) 838-8136
- NPI assigned
- Apr 12, 2021
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | PT0039268 | CA | Primary |
Addresses
Primary practice location
1436 Industrial Park Ave Ste 11
Redlands, CA 92374-4517
Mailing address
157 Sage CT
Calimesa, CA 92320-2092
Phone (909) 838-8136
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 |
|---|---|---|---|
| PT0039268 | CA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618185600000",
"number": "1063092278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "157 SAGE CT",
"city": "CALIMESA",
"state": "CA",
"postal_code": "923202092",
"telephone_number": "909-838-8136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1436 INDUSTRIAL PARK AVE STE 11",
"city": "REDLANDS",
"state": "CA",
"postal_code": "923744517",
"telephone_number": "909-838-8136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MUNOZ",
"first_name": "KRISTIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-12",
"last_updated": "2021-04-12",
"certification_date": "2021-04-12",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": "PT0039268",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redlands, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.