Darryl Rudd

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

1231146885 Issued in CA

Practice address

1100 S Beverly Dr
Los Angeles, CA 90035-1185

Phone

(310) 424-8538

NPI assigned

Apr 3, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1743638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1104620426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 S BEVERLY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351185",
            "telephone_number": "310-424-8538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S BEVERLY DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900351185",
            "telephone_number": "310-424-8538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "DARRYL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-03",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1231132428",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "CA",
            "license": "1231147803",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "1231146885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald G. Rucker, PHARM. D.
• Shanna Rucker, NP
• Leonard Ruckman
• Rachel Anne Elizabeth Rud, LMFT, MS
• Dale A Rudd, ATC
• Nolan Rudd
• Steven Rudd, M.D.
• Monique Eliana Ruddell, OTD, OTR/L, CHT
• Jamie Rudden
• Robert Joseph Rudder Jr.

• Athletic Trainer in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2025; 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.