Cristie Bennett, P.T.

Individual provider Active NPI Physical Medicine & Rehabilitation Physician · Novato, CA

NPI 1104153360 · NPPES record last updated Jan 27, 2010

Key facts

NPI
1104153360
Entity type
Individual (NPI type 1)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
36186 (CA)
Practice address
165 Rowland Way
Ste. 101
Novato, CA 94945-5038
Phone
(415) 898-1311
NPI assigned
Nov 9, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Novato Back Care and Sports Physical Therapy Past Accepting new patients
Sport & Spine Therapy of Marin Inc Past Accepting new patients
Sport & Spine Therapy of Marin Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 36186 CA Yes

Addresses

Primary practice location

165 Rowland Way
Ste. 101
Novato, CA 94945-5038

Mailing address

11 Walker Rd
Mill Valley, CA 94941-1682
Phone (530) 400-8532

Other providers in Novato, CA

All providers in Novato, CA · Physical Medicine & Rehabilitation Physician in California

Sources for this page

Verify at the official NPI Registry.