Marcella Raquel Oden, PT, DPT, DACM, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

19467 Issued in CA

Practice address

4415 Genesee Ave
San Diego, CA 92117-3005

Phone

(619) 800-1974

NPI assigned

Nov 17, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166

  Orthopedic

  Medicare reassignment NPD
• Turn to Acupuncture and Wellness Inc

  • Acupuncturist
  • San Diego, CA
  • NPI 1396506747
  NPD Authorized official

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

{
    "created_epoch": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1316929060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 B AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921181925",
            "telephone_number": "808-783-4330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 GENESEE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921173005",
            "telephone_number": "619-800-1974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Central Ave",
            "address_2": "Naval Health Clinic Hawaii - Professional Affairs",
            "address_purpose": "LOCATION",
            "city": "Pearl Harbor",
            "state": "HI",
            "postal_code": "968604908",
            "country_code": "US",
            "telephone_number": "808-473-2444 x540",
            "fax_number": "808-473-2473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ODEN",
        "first_name": "MARCELLA",
        "middle_name": "RAQUEL",
        "credential": "PT, DPT, DACM, L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "27789",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19467",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "CA",
            "license": "PT27789",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE LICENSE",
            "identifier": "19467",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACUPUNCTURE LICENSE",
            "identifier": "AP4491",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT27789",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Oddou
• Louis Odeesho, PHARMD
• Emily Odegard
• Niccole Marie Odell
• Sarah Mackenzie Odell
• Justin Oderkirk
• Lyssa Wallace Odette, OD
• Ashika Odhav, MD
• Ethel Ntom Odimegwu, FNP
• Mazen Faris Odish, M.D.

• Acupuncturist in San Diego, CA
• Providers in San Diego, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.