MR. PHILLIP JOHN ANTONIO (NPI# 1679082572) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679082572 |
| Entity Type | Individual |
| Full Name | MR. PHILLIP JOHN ANTONIO |
| Practice Address |
18111 Nordhoff Street, California State Northridge Northridge CA 91330-8287 |
| Mailing Address |
8792 Hazeltine Ave Panorama City CA 91402-2552 |
| Practice Telephone | 8186427785 |
| Mailing Telephone | 8186427785 |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2019-09-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | CA | Student, Health Care |
| Street Address |
18111 NORDHOFF STREET, CALIFORNIA STATE NORTHRIDGE |
| City | NORTHRIDGE |
| State | CA |
| Zip Code | 91330-8287 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285285122 | Marilyn Magaram Center for Food Science, Nutrition & Dietetics | Clinic/Center | 18111 Nordhoff Street, Northridge, CA 91330 | 2019-09-23 |
| 1174032072 | Connie Ng | Specialist/Technologist | 18111 Nordhoff St, Northridge, CA 91330 | 2017-09-22 |
| 1417466319 | Wendell John Velasquez | Specialist/Technologist | 18111 Nordhoff St, Northridge, CA 91330 | 2017-09-22 |
| 1831703453 | Habib Toubedjian | Specialist/Technologist | 18111 Nordhoff St Redwood Hall 124, Northridge, CA 91330-0001 | 2020-09-01 |
| 1568012672 | Yugandhar Ramakrishna | Audiologist | 100 Monterey Hall 18111 Nordhoff Street, Northridge, CA 91330-0001 | 2019-09-19 |
| 1013574201 | Michael Kelly Carter | Specialist/Technologist | 1811 Nordoff Street, Northridge, CA 91330-0001 | 2019-05-22 |
| 1548824469 | Youmna Haddad | Speech-Language Pathologist | 18111 Nordhoff Street Monterey Hall 100, Northridge, CA 91330-0001 | 2019-04-25 |
| 1295201820 | Vickie Yu | Speech-Language Pathologist | 18111 Nordhoff Street Monterey Hall Csun, Northridge, CA 91330-0001 | 2018-10-22 |
| 1275024861 | Ellie Ann Jones | Specialist/Technologist | 18411 Nordhoff St, Northridge, CA 91330-0001 | 2018-05-20 |
| 1962911867 | Heather Lauryn Gittins | Specialist/Technologist | 1811 Nordhoff Street, Northridge, CA 91330-0001 | 2017-09-22 |
| Find all providers in zip 91330 | ||||
| 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 |
|---|---|---|---|---|
| 1831703453 | Habib Toubedjian | Specialist/Technologist | 18111 Nordhoff St Redwood Hall 124, Northridge, CA 91330-0001 | 2020-09-01 |
| 1013574201 | Michael Kelly Carter | Specialist/Technologist | 1811 Nordoff Street, Northridge, CA 91330-0001 | 2019-05-22 |
| 1336635531 | Kristel Fortuny Bushner | Specialist/Technologist | 9555 Reseda Blvd, 309, Northridge, CA 91324 | 2018-07-11 |
| 1275024861 | Ellie Ann Jones | Specialist/Technologist | 18411 Nordhoff St, Northridge, CA 91330-0001 | 2018-05-20 |
| 1326551151 | Isabella Leah Pregozen | Specialist/Technologist | 18111 Nordhoff St Redwood Hall, Northridge, CA 91330-4728 | 2017-11-15 |
| 1962911867 | Heather Lauryn Gittins | Specialist/Technologist | 1811 Nordhoff Street, Northridge, CA 91330-0001 | 2017-09-22 |
| 1063921963 | John Daniel Espinoza | Specialist/Technologist | 1811 Nordhoff St Cal State Northridge, Northridge, CA 91330-0001 | 2017-09-22 |
| 1780193680 | Naomi Shapira | Specialist/Technologist | 1811 Nordhoff Street Cal State Northridge, Northridge, CA 91330-0001 | 2017-09-22 |
| 1497264303 | Alexa Erin Dehaeseleer | Specialist/Technologist | 18111 Nordhoff Street Cal. State Northridge, Northridge, CA 91330-8287 | 2017-09-22 |
| 1831147644 | Scott James Shaw | Specialist/Technologist | 18111 Nordhoff St., Northridge, CA 91330-8276 | 2006-05-04 |
| Find all providers in NORTHRIDGE | ||||
| City | NORTHRIDGE |
| Zip Code | 91330 |
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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.