Active NPI
Wendy Anne Newgren, P.T.A.
- Physical Therapy Assistant
- San Rafael, CA
National Provider Identifier
1346576113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- AT149
- Practice address
- 100 Thorndale Drive
San Rafael, CA 94903 - Phone
- (415) 492-2419
- Fax
- (415) 492-0808
- NPI assigned
- Oct 28, 2009
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | AT149 | CA | Primary |
Addresses
Primary practice location
100 Thorndale Drive
San Rafael, CA 94903
Mailing address
35 Sheila Court
Novato, CA 94947
Phone (415) 897-8416
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 |
|---|---|---|---|
| AT149 | CA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehabcare | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Nursing Care Agency
- Novato, CA
- NPI 1700016433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256688000000",
"number": "1346576113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 SHEILA COURT",
"city": "NOVATO",
"state": "CA",
"postal_code": "94947",
"telephone_number": "415-897-8416",
"fax_number": "415-492-0808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 THORNDALE DRIVE",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "94903",
"telephone_number": "415-492-2419",
"fax_number": "415-492-0808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWGREN",
"first_name": "WENDY",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "P.T.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-28",
"last_updated": "2009-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "AT149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.