Active NPI
Rene Andre Maillard, P.T.
- Physical Therapist
- Napa, CA
National Provider Identifier
1306929484
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT24674
- Practice address
- 3421 Villa LN Ste a
Napa, CA 94558-3056 - Phone
- (707) 257-4089
- Fax
- (707) 257-4188
- NPI assigned
- Oct 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT24674 | CA | Primary |
Addresses
Primary practice location
3421 Villa LN Ste a
Napa, CA 94558-3056
Mailing address
1685 E Napa St
Sonoma, CA 95476-3834
Phone (707) 721-6405
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00160372 | Other | CA | RAIL ROAD MEDICARE |
| 0PT246740 | Other | CA | BLUE SHIELD |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT24674 | CA | MD | Physical Therapist |
| 24674 | CA | MD | Dental Clinic/Center |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tokheim Corbett Physical Therapy | Physical Therapist | Past | Accepting new patients |
| Motus Physical Therapy and Performance Inc | Physical Therapist | Past | Accepting new patients |
| TSH Inc. | Physical Therapist | Past | Accepting new patients |
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.
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- Physical Therapist
- Manteca, CA
- NPI 1801384680
-
- Physical Therapist
- Manteca, CA
- NPI 1316979800
-
- Physical Therapist
- Lodi, CA
- NPI 1841396223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1762387200000",
"number": "1306929484",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1685 E NAPA ST",
"city": "SONOMA",
"state": "CA",
"postal_code": "954763834",
"telephone_number": "707-721-6405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3421 VILLA LN STE A",
"city": "NAPA",
"state": "CA",
"postal_code": "945583056",
"telephone_number": "707-257-4089",
"fax_number": "707-257-4188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAILLARD",
"first_name": "RENE",
"middle_name": "ANDRE",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-23",
"last_updated": "2025-11-06",
"certification_date": "2025-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT24674",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAIL ROAD MEDICARE",
"identifier": "P00160372",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "0PT246740",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Napa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.