Individual provider Active NPI

Sixto Jesus Sicilia, PH D

  • Health & Wellness Coach
  • Los Angeles, CA
National Provider Identifier
1417630005
Registry record updated Aug 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Practice address
8170 Beverly Blvd Ste 108
Los Angeles, CA 90048-4533
Phone
(323) 384-3370
NPI assigned
Aug 9, 2023
Last updated
Aug 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X Primary

Addresses

Primary practice location

8170 Beverly Blvd Ste 108
Los Angeles, CA 90048-4533

Mailing address

365 S Mansfield Ave
Los Angeles, CA 90036-3058
Phone (323) 384-3370

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
Credentials
Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1691539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1417630005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 S MANSFIELD AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900363058",
            "telephone_number": "323-384-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8170 BEVERLY BLVD STE 108",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900484533",
            "telephone_number": "323-384-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SICILIA",
        "first_name": "SIXTO",
        "middle_name": "JESUS",
        "name_prefix": "Dr.",
        "credential": "PH D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-09",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.