PEPPERDINE UNIVERSITY (NPI# 1043867971) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043867971 |
| Entity Type | Organization |
| Organization Name | PEPPERDINE UNIVERSITY |
| Practice Address |
24255 Pacific Coast Hwy Malibu CA 90263-3999 |
| Practice Telephone | 3105064316 |
| Mailing Telephone | 3105064316 |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-08-26 |
| Authorized Official Name | NICOLE MARIKO ELBY (REHABILITATION COORDINATOR) |
| Authorized Official Telephone | 3105064169 |
| Authorized Official Credential | PT, DPT, SCS, AT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QS1000X |
Clinic/Center Specialization: Student Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Student Health Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649661661 | Pepperdine University | Chiropractor | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2015-02-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PEPPERDINE UNIVERSITY | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 |
| Street Address |
24255 PACIFIC COAST HWY |
| City | MALIBU |
| State | CA |
| Zip Code | 90263-3999 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386686277 | Kevin Allen Wright | Specialist/Technologist | 24255 Pacific Coast Hwy, Pepperdine University Athletics, Malibu, CA 90263-3999 | 2006-06-12 |
| 1104431451 | Alex Jason Vander Vorste | Specialist/Technologist | 24255 Pacific Coast Hwy, Pepperdine Athletics - Sports Medicine, Malibu, CA 90263 | 2020-09-14 |
| 1275186025 | Karissa Ann Scherer | Specialist/Technologist | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2019-07-22 |
| 1861917577 | Nicole Mariko Elby | Physical Therapist | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2017-08-03 |
| 1063967016 | Katherine Sniffen | Specialist/Technologist | 24255 Pacific Coast Hwy, Athletic Department, Malibu, CA 90263-3999 | 2016-08-19 |
| 1649661661 | Pepperdine University | Chiropractor | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2015-02-12 |
| 1255547667 | Kathleen Eldridge | Psychologist | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2007-05-15 |
| 1518082544 | Geliann Kitsigianis | Internal Medicine | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2007-03-20 |
| 1073647640 | Nancy Safinick | Physician Assistant | 24255 Pacific Coast Hwy, Malibu, CA 90263-3999 | 2007-03-15 |
| 1295865160 | Lucy Kaiser Larson | Pediatrics | 24255 Pacific Coast Hwy, Pepperdine Student Health Center, Malibu, CA 90263-3999 | 2007-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619198355 | Amber Clemmons-trigueros | Counselor | 24255 Pacific Coast Hwy # 3707, Malibu, CA 90263-3999 | 2007-05-01 |
| Taxonomy Code | 261QS1000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Student Health |
| Definition to come... |
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|---|---|---|---|---|
| 1437756103 | Wonderful Center for Health Innovation Inc | Clinic/Center | 14848 Lamberson Ave, Lost Hills, CA 93249 | 2020-10-06 |
| 1811452493 | Wonderful Center for Health Innovation Inc | Clinic/Center | 2070 Veneto St, Delano, CA 93215-9122 | 2019-02-07 |
| 1386134815 | Ventura County Community College District | Clinic/Center | 4667 Telegraph Road, Ventura, CA 93003-3872 | 2018-05-10 |
| 1104339761 | Kern Community College District | Clinic/Center | 1801 Panorama Dr, Bakersfield, CA 93305-1219 | 2017-11-06 |
| 1104342393 | Yosemite Community College District | Clinic/Center | 11600 Columbia College Dr, Sonora, CA 95370-8560 | 2017-08-18 |
| 1750813663 | Yosemite Community College District | Clinic/Center | 435 College Ave, Modesto, CA 95350-5808 | 2017-03-30 |
| 1275937682 | Emmons Student Wellness Center | Clinic/Center | 1600 Campus Rd # F-57, Emmons Wellness Center, Los Angeles, CA 90041-3314 | 2014-10-14 |
| 1083036495 | Nora Anderson | Clinic/Center | 1603 Merion Way, 42 G, Seal Beach, CA 90740-4984 | 2014-01-21 |
| 1386082766 | Esteban E. Torres High School Clinic | Clinic/Center | 4127 East Cesar Chavez Avenue, Los Angeles, CA 90063 | 2013-06-07 |
| 1770920787 | Allan Hancock College | Clinic/Center | 800 S College Dr, Santa Maria, CA 93454-6399 | 2013-05-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.