Yvonne Desarea Liebig, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

37885 Issued in CA

Practice address

21 Tamal Vista Blvd
Suite 175
Corte Madera, CA 94925-1130

Phone

(415) 924-5700

Fax

(415) 924-5723

NPI assigned

Jun 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Essential Balance Physical Therapy, Inc

  • Physical Therapist
  • San Rafael, CA
  • NPI 1770537235
  NPD (past)

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1215224258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 TAMAL VISTA BLVD",
            "address_2": "SUITE 175",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251130",
            "telephone_number": "415-924-5700",
            "fax_number": "415-924-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 TAMAL VISTA BLVD",
            "address_2": "SUITE 175",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251130",
            "telephone_number": "415-924-5700",
            "fax_number": "415-924-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBIG",
        "first_name": "YVONNE",
        "middle_name": "DESAREA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "37885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Leigh, MFT
• Lisa Leung, N.P.
• Judith Levinson, PH.D.
• Molly Van Etten Levit, LMFT
• Daisy Li, OD
• Jessica Claire Lief, LCSW
• Christopher William Lind-White, M.D.
• Petra Renee Lindquist-Kirberg, RN
• Lisa Murphy LCSW
• Little Hands OT

• Physical Therapist in Corte Madera, CA
• Providers in Corte Madera, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.