Individual provider Active NPI

Desiree Traina, M.A

  • Prevention Professional
  • Jacksonville, FL
National Provider Identifier
1831620681
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
License
CNA300372 Issued in FL
Practice address
7406 Fullerton St
200
Jacksonville, FL 32256-3552
Phone
(904) 538-0440
NPI assigned
Mar 23, 2017
Last updated
Mar 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention Professional 405300000X CNA300372 FL Primary

Addresses

Primary practice location

7406 Fullerton St
200
Jacksonville, FL 32256-3552

Mailing address

75 Putter Dr
Palm Coast, FL 32164-7404
Phone (904) 607-0223

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
CNA300372FLMDPrevention Professional

Practice roles

OrganizationSpecialtyStatusNew patients
Ingenios Health Co. PastSince Oct 6, 2014 Accepting new patients
Pophealthcare, LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1831620681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PUTTER DR",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321647404",
            "telephone_number": "904-607-0223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7406 FULLERTON ST",
            "address_2": "200",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322563552",
            "telephone_number": "904-538-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAINA",
        "first_name": "DESIREE",
        "credential": "M.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-23",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "",
            "desc": "Prevention Professional",
            "state": "FL",
            "license": "CNA300372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.