Marissa Wahl, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

52029 Issued in CA

Practice address

11420 Warner Ave
Fountain Valley, CA 92708-2529

Phone

(657) 204-2959

NPI assigned

May 1, 2023

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)

Not enrolled

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

{
    "created_epoch": "1682899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1336838937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 VIA MARINA APT 305",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902924502",
            "telephone_number": "570-878-5273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11420 WARNER AVE",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927082529",
            "telephone_number": "657-204-2959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAHL",
        "first_name": "MARISSA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-01",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "52029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Nhung My Vuong
• Kevin Minh Vuong, BEHAVIOR TECHNICIAN
• Minh Uyen Chau Vuong, PHARM.D
• Mindy Vuu, NP-BC
• William Vy, DC
• Walgreen Co (Walgreens #12573)
• Walgreen Co (Walgreens #09534)
• Walgreen Co. (Walgreens Specialty Pharmacy #12694)
• Alyssa Walker, BT
• Cynthia Guadalupe Walker

• Physical Therapy Assistant in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; 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.