Individual provider Active NPI

Malia Matteo, ATC

  • Athletic Trainer
  • Oceanside, CA
National Provider Identifier
1093265118
Registry record updated Oct 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000018448 Issued in CA
Practice address
1 Barnard Dr
Oceanside, CA 92056-3820
Phone
(760) 757-2121
NPI assigned
Oct 12, 2016
Last updated
Oct 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2016

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 2000018448 CA Primary

Addresses

Primary practice location

1 Barnard Dr
Oceanside, CA 92056-3820

Mailing address

1616 S Pacific St
Apt E
Oceanside, CA 92054-5830
Phone (760) 522-2692

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

LicenseStateTypeSpecialty
2000018448CAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1093265118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 S PACIFIC ST",
            "address_2": "APT E",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920545830",
            "telephone_number": "760-522-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARNARD DR",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920563820",
            "telephone_number": "760-757-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTEO",
        "first_name": "MALIA",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "2000018448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.