Individual provider Active NPI

Jeremy Adam Rasso-Cortez

  • Athletic Trainer
  • Moreno Valley, CA
National Provider Identifier
1891200184
Registry record updated Dec 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
Practice address
17750 Lasselle St
Moreno Valley, CA 92551-6300
Phone
(951) 485-6200
NPI assigned
Dec 8, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2017

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 Primary

Addresses

Primary practice location

17750 Lasselle St
Moreno Valley, CA 92551-6300

Mailing address

5880 Lochmoor Dr Apt 51
Riverside, CA 92507-8511
Phone (951) 567-9466

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

NPI Registry JSON

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

{
    "created_epoch": "1512691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512691200000",
    "number": "1891200184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 LOCHMOOR DR APT 51",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925078511",
            "telephone_number": "951-567-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17750 LASSELLE ST",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925516300",
            "telephone_number": "951-485-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASSO-CORTEZ",
        "first_name": "JEREMY",
        "middle_name": "ADAM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-08",
        "last_updated": "2017-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moreno Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.