Active NPI
Justine Phillips, ATC
- Athletic Trainer
- La Mesa, CA
National Provider Identifier
1356936728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- BOC381720
- Practice address
- 6731 Alamo Way
La Mesa, CA 91942-5807 - Phone
- (714) 504-3478
- NPI assigned
- Mar 7, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rehabilitation Practitioner | 225400000X | 2000040731 | CA | |
| Athletic Trainer | 2255A2300X | BOC381720 | CA | Primary |
Addresses
Primary practice location
6731 Alamo Way
La Mesa, CA 91942-5807
Mailing address
6731 Alamo Way
La Mesa, CA 91942-5807
Phone (714) 504-3478
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2000040731 | CA | MD | Rehabilitation Practitioner |
| BOC381720 | CA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1615075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615420800000",
"number": "1356936728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6731 ALAMO WAY",
"city": "LA MESA",
"state": "CA",
"postal_code": "919425807",
"telephone_number": "714-504-3478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6731 ALAMO WAY",
"city": "LA MESA",
"state": "CA",
"postal_code": "919425807",
"telephone_number": "714-504-3478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "JUSTINE",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-07",
"last_updated": "2021-03-11",
"certification_date": "2021-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "225400000X",
"taxonomy_group": "",
"desc": "Rehabilitation Practitioner",
"state": "CA",
"license": "2000040731",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": "BOC381720",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Mesa, CA
- Thanhtruc Hoang Phan, FNP-C
- Philip D Szold MD Inc
- Phillip Dickinson, M.D., a Professional Corporation
- Jarrad Marshall Phillips, ATC
- Julie Christine Phillips, M.D.
- Lanard Phillips Sr.
- Kelly Phommahaxay, M.D.
- Physical Therapy and Sports Medicine Center
- Physician Assistant Surgassist, Inc.
- Physiotherapy Associates, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.