Andy Sepulveda, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

4515 Portola Pkwy
Irvine, CA 92620-2200

Phone

(949) 936-7244

NPI assigned

Sep 16, 2022

Last updated

Sep 16, 2022By the provider in NPPES

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

Other identifiers 1

Other names 1

• Ms. Andrea Sepulveda Other name

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": "1663286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1710609565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1797 N WILLOW WOODS DR UNIT C",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928071459",
            "telephone_number": "714-404-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 PORTOLA PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926202200",
            "telephone_number": "949-936-7244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPULVEDA",
        "first_name": "ANDY",
        "name_prefix": "Ms.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-16",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOC",
            "identifier": "020002011",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANDREA",
            "last_name": "SEPULVEDA",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Athletic Trainer in Irvine, CA
• Providers in Irvine, CA by specialty
• Athletic Trainer in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.