Individual provider Active NPI

Malinda Marshall, PT

  • Physical Therapist
  • Los Gatos, CA
National Provider Identifier
1174869523
Registry record updated Jan 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
39721 Issued in CA
Practice address
340 Dardanelli LN Ste 23
Los Gatos, CA 95032
Phone
(408) 884-8356
NPI assigned
Dec 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 39721 CA Primary

Addresses

Primary practice location

340 Dardanelli LN Ste 23
Los Gatos, CA 95032

Mailing address

340 Dardanelli LN Ste 23
Los Gatos, CA 95032-1418
Phone (408) 884-8356

Other practice location 1

415 N Crescent Dr
Suite 130
Beverly Hills, CA 90210-4860
Phone (310) 273-0877

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

LicenseStateTypeSpecialty
39721CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Specialists, Inc Physical Therapist PastSince Nov 1, 2013 Accepting new patients
Prendergast and Rummer Phys Therapy Pelvic Health & Rehabiliation Ctr Physical Therapist PastSince May 24, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547337600000",
    "number": "1174869523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 DARDANELLI LN STE 23",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321418",
            "telephone_number": "408-884-8356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 DARDANELLI LN STE 23",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-884-8356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 N Crescent Dr",
            "address_2": "Suite 130",
            "address_purpose": "LOCATION",
            "city": "Beverly Hills",
            "state": "CA",
            "postal_code": "902104860",
            "country_code": "US",
            "telephone_number": "310-273-0877",
            "fax_number": "310-273-1189",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "MALINDA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-12",
        "last_updated": "2019-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "39721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2019; 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.