Active NPI
Joshua Shrivastava, MA, PTA, ATC, CSCS
- Athletic Trainer
- Mission Viejo, CA
National Provider Identifier
1992027015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 25512 Gloriosa Dr
Mission Viejo, CA 92691-4644 - Phone
- (818) 624-6162
- NPI assigned
- Feb 16, 2010
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary | ||
| Physical Therapy Assistant | 225200000X | AT 10372 | CA |
Addresses
Primary practice location
25512 Gloriosa Dr
Mission Viejo, CA 92691-4644
Mailing address
25512 Gloriosa Dr
Mission Viejo, CA 92691-4644
Phone (818) 624-6162
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT 10372 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392768000000",
"number": "1992027015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25512 GLORIOSA DR",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926914644",
"telephone_number": "818-624-6162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25512 GLORIOSA DR",
"city": "MISSION VIEJO",
"state": "CA",
"postal_code": "926914644",
"telephone_number": "818-624-6162"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHRIVASTAVA",
"first_name": "JOSHUA",
"name_prefix": "Mr.",
"credential": "MA, PTA, ATC, CSCS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-02-16",
"last_updated": "2014-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT 10372",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mission Viejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.