Ainsley Nyeinchun McClure, ATC
Individual provider Active NPI Athletic Trainer · Tomales, CA
NPI 1164062964 · NPPES record last updated Jan 9, 2020
Key facts
- NPI
- 1164062964
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 2000037024 (CA)
- Practice address
- 3850 Irvin Rd
Tomales, CA 94971 - Phone
- (415) 755-5141
- NPI assigned
- Jan 9, 2020
- Sex
- Male
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2000037024 | CA | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2000037024 | CA | Yes |
Addresses
Primary practice location
3850 Irvin Rd
Tomales, CA 94971
Mailing address
3850 Irvin Rd
Tomales, CA 94971
Other providers in Tomales, CA
All providers in Tomales, 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 Jan 9, 2020. 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.