SPORT & SPINE THERAPY OF MARIN INC (NPI# 1861852964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1861852964 |
| Entity Type | Organization |
| Organization Name | SPORT & SPINE THERAPY OF MARIN INC |
| Practice Address |
719 Southpoint Blvd Suite A Petaluma CA 94954-1495 |
| Mailing Address |
Po Box 950 Novato CA 94948-0950 |
| Practice Telephone | 7079818062 |
| Practice Fax Number | 7079818684 |
| Enumeration Date | 2016-03-02 |
| Last Update Date | 2020-10-08 |
| Authorized Official Name | STEVEN THOMPSON (OWNER/CEO) |
| Authorized Official Telephone | 4158981311 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174578199 | Sport & Spine Therapy of Marin Inc | Physical Therapist | 88 Rowland Way, Suite 250, Novato, CA 94945-5042 | 2006-05-24 |
| 1154388577 | Sport & Spine Therapy of Marin Inc | Clinic/Center | 220 Greenfield Ave, San Anselmo, CA 94960-2416 | 2006-04-28 |
| Street Address |
719 SOUTHPOINT BLVD SUITE A |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-1495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891793741 | Raymond Edward Erny | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| 1003280801 | Next Level Physical Therapy Inc. | Physical Therapist | 719 Southpoint Blvd, Suite A, Petaluma, CA 94954-1495 | 2015-11-17 |
| 1912085523 | Sheryl Anne Garrett | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2006-11-01 |
| 1851338537 | Keith F. Korver, M.d., Inc. | Surgery | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-8003 | 2006-06-01 |
| 1992797435 | Noel E Santo Domingo | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-08-19 |
| 1003815606 | Northern California Medical Assoc Inc | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-18 |
| 1669470522 | Richard Foster Gaston | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| 1518965490 | Kenneth Lewis Lehrman | Internal Medicine | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-1495 | 2005-07-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275098071 | Alexander Oberman | Physical Therapist | 3 Indigo Dr Unit 101, Petaluma, CA 94954-6988 | 2019-02-05 |
| 1770612087 | Barbara Ann Haushalter | Physical Therapist | 222 Weller St Ste 208, Petaluma, CA 94952-7108 | 2007-03-04 |
| 1548345390 | Mitchell Kauk | Physical Therapist | 224a Weller St, Petaluma, CA 94952-3136 | 2006-10-26 |
| 1790860542 | Craig Steven Hamley | Physical Therapist | 1476 Professional Dr Ste 504, Petaluma, CA 94954-1500 | 2006-10-26 |
| 1972667947 | Mitchell Kauk | Physical Therapist | 224a Weller St, Petaluma, CA 94952-3136 | 2006-12-21 |
| 1245310549 | Kevin Thomas White | Physical Therapist | 169 Lynch Creek Way, Petaluma, CA 94954-2344 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568063311 | Kayla Utley | Physical Therapist | 5201 Norris Canyon Rd Ste 230, San Ramon, CA 94583-5405 | 2020-11-06 |
| 1184225054 | Vuk Ekmecic | Physical Therapist | 7908 Rancho Fanita Dr Spc 23, Santee, CA 92071-3421 | 2020-11-05 |
| 1932700283 | Christopher Lui | Physical Therapist | 21621 E Bluebell Ct, Walnut, CA 91789-1443 | 2020-11-03 |
| 1952900789 | Sierra Speck | Physical Therapist | 11701 Wilshire Blvd Ste 14b1, Los Angeles, CA 90025-1547 | 2020-10-22 |
| 1992312086 | Heidi Lynne Anders | Physical Therapist | 5805 W 8th St Apt 205, Los Angeles, CA 90036-4576 | 2020-09-23 |
| 1578176780 | Patricia Isabella Commer | Physical Therapist | 4146 Randolph Ave, Oakland, CA 94602-1314 | 2020-08-26 |
| 1376151126 | Yifu Zhou | Physical Therapist | 1625 W Olympic Blvd Ste 790, Los Angeles, CA 90015-3809 | 2020-07-17 |
| 1033732250 | Sync Physical Therapy & Yoga Inc | Physical Therapist | 5100 Marlborough Dr Ste 101, San Diego, CA 92116-2020 | 2020-05-21 |
| 1043830961 | Dr. Holly Physical Therapy | Physical Therapist | 4500 Shepard St, Bakersfield, CA 93313-2326 | 2020-04-21 |
| 1861011744 | Lauren Jarmusz | Physical Therapist | 1107 2nd Ave Apt 408, Redwood City, CA 94063-4036 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
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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.