Individual provider Active NPI

Robert Salcedo

  • Athletic Trainer
  • Sacramento, CA
National Provider Identifier
1669108197
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
Y9524327 Issued in CA
Practice address
2905 38TH Ave
Sacramento, CA 95824-2424
Phone
(267) 466-8830
NPI assigned
Jul 27, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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 Y9524327 CA Primary

Addresses

Primary practice location

2905 38TH Ave
Sacramento, CA 95824-2424

Mailing address

2905 38TH Ave
Sacramento, CA 95824-2424
Phone (267) 466-8830

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
Y9524327CAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1669108197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2905 38TH AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958242424",
            "telephone_number": "267-466-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 38TH AVE",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958242424",
            "telephone_number": "267-466-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALCEDO",
        "first_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "Y9524327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.