Keith A Candelaria, MS, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

2000007169 Issued in CA

Practice address

13847 Earlham Dr
Whittier, CA 90602-6669

Phone

(562) 907-4965

Fax

(562) 945-8024

NPI assigned

Nov 1, 2016

Last updated

Nov 1, 2016By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477958400000",
    "number": "1841742236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9253 MYRON ST",
            "city": "PICO RIVERA",
            "state": "CA",
            "postal_code": "906605246",
            "telephone_number": "562-544-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13847 EARLHAM DR",
            "city": "WHITTIER",
            "state": "CA",
            "postal_code": "906026669",
            "telephone_number": "562-907-4965",
            "fax_number": "562-945-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANDELARIA",
        "first_name": "KEITH",
        "middle_name": "A",
        "credential": "MS, ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "2000007169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alina Campbell, MFT
• Kristine Campisi
• Danielle Campos
• Shawndra E Campos
• Can Thanh Ngo, MD, Inc.
• Jaclyn Candelas
• Roberto Canela
• Lani Romani Cante, BCBA
• Kimson Silverio Cantos
• Elysse Gloria Cantu

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.