Jessica Mattos
Individual provider Active NPI Athletic Trainer · Prunedale, CA
NPI 1093215352 · NPPES record last updated Feb 13, 2018
Key facts
- NPI
- 1093215352
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 20150 Tarawild CT
Prunedale, CA 93907-1411 - Phone
- (831) 818-5711
- NPI assigned
- Feb 13, 2018
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
20150 Tarawild CT
Prunedale, CA 93907-1411
Mailing address
20150 Tarawild CT
Prunedale, CA 93907-1411
Other providers in Prunedale, CA
- Alexander Albert Jaque
- Lucas Jared Johnson
- Mark Juarez
- Briana Lawson
- Cynthia Mangiola
- Katherin Mendoza
- Jennah Montemayor
- Steven James Moran
- Michael Christopher Nease
- Munvir Singh Pannu
All providers in Prunedale, CA · Athletic Trainer in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.