Active NPI
Jonathan Gedalia, ATC, NREMT
- Athletic Trainer
- Valencia, CA
National Provider Identifier
1922520246
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 27801 Dickason Dr
Valencia, CA 91355-4012 - Phone
- (661) 294-1188
- NPI assigned
- Jul 7, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Basic Emergency Medical Technician | 146N00000X | E084823 | CA | |
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
27801 Dickason Dr
Valencia, CA 91355-4012
Mailing address
27801 Dickason Dr
Valencia, CA 91355-4012
Phone (818) 808-3551
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 |
|---|---|---|---|
| E084823 | CA | MD | Basic Emergency Medical Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1499385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709078400000",
"number": "1922520246",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27801 DICKASON DR",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913554012",
"telephone_number": "818-808-3551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27801 DICKASON DR",
"city": "VALENCIA",
"state": "CA",
"postal_code": "913554012",
"telephone_number": "661-294-1188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEDALIA",
"first_name": "JONATHAN",
"name_prefix": "Mr.",
"credential": "ATC, NREMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-07-07",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "146N00000X",
"taxonomy_group": "",
"desc": "Emergency Medical Technician, Basic",
"state": "CA",
"license": "E084823",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valencia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.