Martha Ann Bass, PHYSICAL THERAPIST
Individual provider Active NPI Contractor · Anaheim, CA
NPI 1336450436 · NPPES record last updated Jun 23, 2010
Key facts
- NPI
- 1336450436
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- PT 7143 (CA)
- Practice address
- 6210 E Twin Peak Cir
Anaheim, CA 92807-4848 - Phone
- (714) 974-5553
- Fax
- (714) 283-1896
- NPI assigned
- Jun 23, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT 7143 | CA | MD | Community Health Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | PT 7143 | CA | Yes |
| Community Health Worker | 172V00000X | PT 7143 | CA |
Addresses
Primary practice location
6210 E Twin Peak Cir
Anaheim, CA 92807-4848
Mailing address
6210 E Twin Peak Cir
Anaheim, CA 92807-4848
Phone (714) 974-5553
Other providers in Anaheim, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.