Individual provider Active NPI

Danielle Corissa York, ATC

  • Athletic Trainer
  • Modesto, CA
National Provider Identifier
1285278366
Registry record updated Nov 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
2000011306
Practice address
523 Glass LN Ste 4a
Modesto, CA 95356-9233
Phone
(209) 284-1909
NPI assigned
Nov 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic TrainerGroup: 193400000X SINGLE SPECIALTY GROUP 2255A2300X 2000011306 Primary

Addresses

Primary practice location

523 Glass LN Ste 4a
Modesto, CA 95356-9233

Mailing address

1425 East Ave
Turlock, CA 95380-4210
Phone (209) 485-4882

Other names 1

  • Danielle Corissa Stern Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1572566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572566400000",
    "number": "1285278366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 EAST AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953804210",
            "telephone_number": "209-485-4882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 GLASS LN STE 4A",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953569233",
            "telephone_number": "209-284-1909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORK",
        "first_name": "DANIELLE",
        "middle_name": "CORISSA",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-01",
        "last_updated": "2019-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": "2000011306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "STERN",
            "middle_name": "CORISSA",
            "credential": "ATC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Modesto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2019; 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.