Active NPI
Marilyn Eldridge
- Pediatric Physical Therapist
- Santa Ana, CA
National Provider Identifier
1295784528
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 9060
- Practice address
- 200 W Santa Ana Blvd
Santa Ana, CA 92701-4134 - Phone
- (714) 347-0390
- NPI assigned
- May 5, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9060 | CA | |
| Pediatric Physical Therapist | 2251P0200X | 9060 | CA | Primary |
Addresses
Primary practice location
200 W Santa Ana Blvd
Santa Ana, CA 92701-4134
Mailing address
200 W Santa Ana Blvd
Suite 100
Santa Ana, CA 92701-4134
Phone (714) 347-0390
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 |
|---|---|---|---|
| 9060 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1185148800000",
"number": "1295784528",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 W SANTA ANA BLVD",
"address_2": "SUITE 100",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927014134",
"telephone_number": "714-347-0390"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 W SANTA ANA BLVD",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927014134",
"telephone_number": "714-347-0390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELDRIDGE",
"first_name": "MARILYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2007-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "9060",
"primary": false
},
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "9060",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.