Active NPI
Monica Liliana Grove, ATC
- Athletic Trainer
- Walnut, CA
National Provider Identifier
1669610911
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 02040271
- Practice address
- 1100 N Grand Ave
Walnut, CA 91789-1341 - Phone
- (909) 594-5611
- NPI assigned
- Jan 24, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 02040271 | CA | Primary |
Addresses
Primary practice location
1100 N Grand Ave
Walnut, CA 91789-1341
Mailing address
629 Shenandoah Rd
Corona, CA 92879-8509
Phone (951) 207-0722
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
| License | State | Type | Specialty |
|---|---|---|---|
| 02040271 | CA | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1232755200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232755200000",
"number": "1669610911",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 SHENANDOAH RD",
"city": "CORONA",
"state": "CA",
"postal_code": "928798509",
"telephone_number": "951-207-0722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 N GRAND AVE",
"city": "WALNUT",
"state": "CA",
"postal_code": "917891341",
"telephone_number": "909-594-5611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROVE",
"first_name": "MONICA",
"middle_name": "LILIANA",
"name_prefix": "Mrs.",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-24",
"last_updated": "2009-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "CA",
"license": "02040271",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.