Amanda Avalos
Individual provider Active NPI Athletic Trainer · La Verne, CA
NPI 1184250052 · NPPES record last updated Mar 23, 2020
Key facts
- NPI
- 1184250052
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 1950 3Rd St
La Verne, CA 91750-4401 - Phone
- (626) 279-1867
- NPI assigned
- Mar 23, 2020
- Sex
- Female
- Sole proprietor
- Yes
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
1950 3Rd St
La Verne, CA 91750-4401
Mailing address
1950 3Rd St
La Verne, CA 91750-4401
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- Maurice L Autrey
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- B.M.E Medical Group
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- Dcorey Baines
- Camilo P Balacuit III III
All providers in La Verne, 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 Mar 23, 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.