Individual provider Active NPI

Breanna J Yep

  • Athletic Trainer
  • West Covina, CA
National Provider Identifier
1225741986
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000056108 Issued in CA
Practice address
3241 E Millridge Dr
West Covina, CA 91792-2942
Phone
(909) 436-7896
NPI assigned
Dec 27, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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 2000056108 CA Primary

Addresses

Primary practice location

3241 E Millridge Dr
West Covina, CA 91792-2942

Mailing address

3241 E Millridge Dr
West Covina, CA 91792-2942
Phone (909) 436-7896

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
2000056108CAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1225741986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3241 E MILLRIDGE DR",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917922942",
            "telephone_number": "909-436-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 E MILLRIDGE DR",
            "city": "WEST COVINA",
            "state": "CA",
            "postal_code": "917922942",
            "telephone_number": "909-436-7896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEP",
        "first_name": "BREANNA",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "2000056108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Covina, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.