Mary Eugenia Aja, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

4901 E Carson St
Long Beach, CA 90808-1780

Phone

(562) 938-4385

NPI assigned

Dec 11, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1558967760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4901 E CARSON ST # G19",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081780",
            "telephone_number": "562-716-2957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 E CARSON ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908081780",
            "telephone_number": "562-938-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AJA",
        "first_name": "MARY",
        "middle_name": "EUGENIA",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.lbcc.edu/",
            "affiliation": "N",
            "address_1": "4901 E Carson St",
            "city": "Long Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "908081780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Athletic Trainer in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.