Monica Lisette Islas, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000036793 Issued in CA

Practice address

6035 Giant Rd
Richmond, CA 94806-2388

Phone

(209) 675-1864

NPI assigned

May 22, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1684713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1275225153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 BROADWAY ST APT 325",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945202646",
            "telephone_number": "209-675-1864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6035 GIANT RD",
            "city": "RICHMOND",
            "state": "CA",
            "postal_code": "948062388",
            "telephone_number": "209-675-1864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1771 Broadway St Apt 325",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "CA",
            "postal_code": "945202646",
            "country_code": "US",
            "telephone_number": "209-675-1864",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3151 Regatta Ave # B60",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "948046411",
            "country_code": "US",
            "telephone_number": "209-675-1864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ISLAS",
        "first_name": "MONICA",
        "middle_name": "LISETTE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-22",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "2000036793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Richmond, CA
• Providers in Richmond, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2023; 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.