Individual provider Active NPI

Trevor Newberry

  • Athletic Trainer
  • Huntington Beach, CA
National Provider Identifier
1366958340
Registry record updated Dec 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
BOC256909 Issued in CA
Practice address
8081 Holland Dr
Huntington Beach, CA 92647-6345
Phone
(310) 987-0209
NPI assigned
Dec 28, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2017

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 BOC256909 CA Primary

Addresses

Primary practice location

8081 Holland Dr
Huntington Beach, CA 92647-6345

Mailing address

8081 Holland Dr
Huntington Beach, CA 92647-6345

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
BOC256909CAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514419200000",
    "number": "1366958340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 HOLLAND DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 HOLLAND DR",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926476345",
            "telephone_number": "310-987-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBERRY",
        "first_name": "TREVOR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-28",
        "last_updated": "2017-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "BOC256909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2017; 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.