Functional Medicine Specialists

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

534073 Issued in CA

Legal business name

FUNCTIONAL MEDICINE SPECIALISTS

Doing business as

Functional Medicine Specialists Nursing Practitioner Services

Practice address

2210 Encinitas Blvd Ste T
Encinitas, CA 92024-4376

Phone

(760) 270-3990

NPI assigned

Feb 27, 2017

Last updated

Feb 27, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Cambria Marcy Demarco Perry, NP

Title

Owner

Phone

(619) 306-6949

Specialties & licenses 1

Addresses

Other names 1

• Functional Medicine Specialists Nursing Practitioner Services Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488153600000",
    "number": "1164962932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2210 ENCINITAS BLVD STE T",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244376",
            "telephone_number": "760-270-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 ENCINITAS BLVD STE T",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920244376",
            "telephone_number": "760-270-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL MEDICINE SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A",
        "authorized_official_last_name": "DEMARCO PERRY",
        "authorized_official_first_name": "CAMBRIA",
        "authorized_official_middle_name": "MARCY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "619-306-6949",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "534073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Functional Medicine Specialists Nursing Practitioner Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yuan Zhi Fu, LIC ACP
• Mary Anne Fuchs, M.D.
• Function for Life PT (Longevity PT)
• Function for Life PT Inc (Longevity Physical Therapy)
• Functional Impact Physical Therapy Inc.
• Nicholas Anthony Furnari, MA
• Kevin M Fussell, M.D.
• Oceanna Gage, LCSW
• Jessica Gaines, PSY.D.
• Cynthia Galindo

• Clinic/Center in Encinitas, CA
• Providers in Encinitas, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.