Active NPI
Amanda Duben
- Athletic Trainer
- Northridge, CA
National Provider Identifier
1366009557
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 18111 Nordhoff St
Northridge, CA 91330-0001 - Phone
- (818) 677-1200
- NPI assigned
- May 22, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
18111 Nordhoff St
Northridge, CA 91330-0001
Mailing address
25519 Clemens CT
Stevenson Ranch, CA 91381-1526
Phone (661) 993-3147
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 | Other | CA | RESPIRATORY, DEVELOPMENTAL, REHABILITATIVE AND RESTORATIVE SERVICE PROVIDER |
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": "1558483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630540800000",
"number": "1366009557",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25519 CLEMENS CT",
"city": "STEVENSON RANCH",
"state": "CA",
"postal_code": "913811526",
"telephone_number": "661-993-3147"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18111 NORDHOFF ST",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913300001",
"telephone_number": "818-677-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBEN",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-22",
"last_updated": "2021-09-02",
"certification_date": "2021-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RESPIRATORY, DEVELOPMENTAL, REHABILITATIVE AND RESTORATIVE SERVICE PROVIDER",
"identifier": "22",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.