JESSICA SOFIE LIUTKUS (NPI# 1306369715) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306369715 |
| Entity Type | Individual |
| Full Name | JESSICA SOFIE LIUTKUS |
| Credential | ATC |
| Practice Address |
13010 Paseo Lucido San Diego CA 92128-4478 |
| Mailing Address |
16543 S Catawba Rd Homer Glen IL 60491-9633 |
| Practice Telephone | 8584854800 |
| Mailing Telephone | 7738656343 |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2017-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
13010 PASEO LUCIDO |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92128-4478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346637279 | Robert Gamble Bowers Jr. | Specialist/Technologist | 13010 Paseo Lucido, San Diego, CA 92128-4478 | 2015-04-17 |
| 1982255477 | Mental Health Systems, Inc. | Community/Behavioral Health | 13010 Paseo Lucido, San Diego, CA 92128-4478 | 2019-09-25 |
| 1962915926 | Brooke Ann Hanners | Specialist/Technologist | 13010 Paseo Lucido, San Diego, CA 92128-4478 | 2017-11-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585371 | Alicia Ford | Behavior Technician | 1170 Bernardo Plaza Court, Suite 350, San Diego, CA 92128 | 2020-07-08 |
| 1164087573 | Madeleine White | Dietitian, Registered | 16685 W Bernardo Dr, Suite 121, San Diego, CA 92128 | 2019-05-01 |
| 1053807677 | Joele Ghosn | Speech-Language Pathologist | 11838 Bernardo Plaza Ct #110, San Diego, CA 92128 | 2018-07-06 |
| 1376034348 | Eddie Reginald Burston II | In Home Supportive Care | 12727 Camino Emparrado, San Diego, CA 92128 | 2018-05-24 |
| 1336659218 | Ryan Fong | Physician Assistant | 15004 Innovation Drive (s97), San Diego, CA 92128 | 2017-10-05 |
| 1508316191 | Araceli Flores | Behavioral Analyst | 15737 Innovation Dr, Suite 200, San Diego, CA 92128 | 2016-10-07 |
| 1003283961 | Katherine Dishner | Hearing Instrument Specialist | 16766 Bernardo Center Dr Ste 206, San Diego, CA 92128 | 2015-08-27 |
| 1205212586 | Mobilia Dmd Inc. | Point of Service | 12405 Rancho Bernardo Rd., San Diego, CA 92128 | 2015-08-10 |
| 1346623634 | Angela Christine Storck-petersen | Dietitian, Registered | 11768 Caminito Corriente, San Diego, CA 92128 | 2015-07-04 |
| 1134526874 | Breeana Rose Lancaster | Speech-Language Pathologist | 11838 Bernardo Plaza Ct. Suite 110, Kids Therapy Associates, San Diego, CA 92128 | 2014-11-24 |
| Find all providers in zip 92128 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215540075 | Brianna Paige Corallo | Specialist/Technologist | 4453 Carling Dr, San Diego, CA 92115-5527 | 2020-08-30 |
| 1518578954 | Mina Markley Castleman | Specialist/Technologist | 3864 35th St Apt 12, San Diego, CA 92104-3162 | 2020-08-10 |
| 1518575661 | Jason William Switzer | Specialist/Technologist | 3328 6th Ave, San Diego, CA 92103-5706 | 2020-07-15 |
| 1346858461 | Eduardo Alberto Gallardo Ziramba | Specialist/Technologist | 3142 Ingelow St, San Diego, CA 92106-2222 | 2020-07-14 |
| 1144847641 | Joseph C Claborn | Specialist/Technologist | 7130 Miramar Rd, San Diego, CA 92121-2353 | 2020-06-30 |
| 1215551551 | Jacob Riley Callahan | Specialist/Technologist | 5302 55th St, San Diego, CA 92182-0001 | 2020-06-02 |
| 1598385932 | Nicole Arimboanga Brisco | Specialist/Technologist | 10510 Marauder Way, San Diego, CA 92126-3275 | 2020-04-24 |
| 1861059925 | Tomoko Ohkubo-kuo | Specialist/Technologist | 8780 Parkplace Ct, San Diego, CA 92123-6406 | 2019-05-23 |
| 1720645864 | Bianca Mattioli | Specialist/Technologist | 6191 Rancho Mission Rd Unit 113, San Diego, CA 92108-2238 | 2019-05-23 |
| 1427614700 | Jason Mcmullen | Specialist/Technologist | 3421 36th St Apt 15, San Diego, CA 92104-4434 | 2019-05-13 |
| Find all providers in SAN DIEGO | ||||
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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.