Active NPI
Jonathan David Semillo, ATC, LAT
- Athletic Trainer
- Sacramento, CA
National Provider Identifier
1891592473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-10256506
- Practice address
- 6000 J St
Sacramento, CA 95819-2605 - Phone
- (916) 278-9355
- NPI assigned
- Feb 28, 2025
- Sex
- Male
- 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 | AT-10256506 | OR | Primary |
Addresses
Primary practice location
6000 J St
Sacramento, CA 95819-2605
Mailing address
10424 Grass Valley CT
Stockton, CA 95209-4549
Phone (209) 938-7131
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 |
|---|---|---|---|
| AT-10256506 | OR | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767916800000",
"number": "1891592473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10424 GRASS VALLEY CT",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952094549",
"telephone_number": "209-938-7131"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 J ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958192605",
"telephone_number": "916-278-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEMILLO",
"first_name": "JONATHAN",
"middle_name": "DAVID",
"credential": "ATC, LAT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-02-28",
"last_updated": "2026-01-09",
"certification_date": "2026-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "OR",
"license": "AT-10256506",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.