Active NPI
Marise Akemi Roberts, MPT
- Physical Therapist
- Fremont, CA
National Provider Identifier
1073923470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 40980
- Practice address
- 4081 Park Center LN Apt B
Fremont, CA 94538-2108 - Phone
- (510) 861-8102
- NPI assigned
- May 7, 2014
- Last updated
- May 7, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 40980 | CA | Primary |
Addresses
Primary practice location
4081 Park Center LN Apt B
Fremont, CA 94538-2108
Mailing address
4081 Park Center LN Apt B
Fremont, CA 94538-2108
Phone (510) 861-8102
Other names 1
- Marise Akemi Ishizuka
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40980 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399420800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399420800000",
"number": "1073923470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4081 PARK CENTER LN APT B",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382108",
"telephone_number": "510-861-8102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4081 PARK CENTER LN APT B",
"city": "FREMONT",
"state": "CA",
"postal_code": "945382108",
"telephone_number": "510-861-8102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTS",
"first_name": "MARISE",
"middle_name": "AKEMI",
"credential": "MPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-07",
"last_updated": "2014-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "40980",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARISE",
"last_name": "ISHIZUKA",
"middle_name": "AKEMI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Fremont, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.