The Serenity Center

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

20000023557 Issued in CA

Legal business name

THE SERENITY CENTER

Practice address

9320 Baseline Rd
Suite a-1
Rancho Cucamonga, CA 91701-5829

Phone

(909) 652-2147

NPI assigned

Jan 31, 2017

Organization subpart

No

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

Authorized official

Name

Amy Jean Belk

Title

Owner/Operator

Phone

(190) 965-2147

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1485820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1528505302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9320 BASELINE RD",
            "address_2": "SUITE A-1",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015829",
            "telephone_number": "909-652-2147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 BASELINE RD",
            "address_2": "SUITE A-1",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917015829",
            "telephone_number": "909-652-2147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SERENITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-31",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "BELK",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "190-965-2147"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "20000023557",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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