Active NPI
Marisa Lynn Beltran del Rio, CMT
- Massage Therapist
- Santa Rosa, CA
National Provider Identifier
1467069260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 80433
- Practice address
- 1510 Kona PL
Santa Rosa, CA 95403-8605 - Phone
- (269) 953-8899
- NPI assigned
- Sep 25, 2020
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 80433 | CA | Primary |
Addresses
Primary practice location
1510 Kona PL
Santa Rosa, CA 95403-8605
Mailing address
1510 Kona PL
Santa Rosa, CA 95403-8605
Phone (269) 953-8899
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80433 | Other | CA | CMTA |
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 |
|---|---|---|---|
| 80433 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600992000000",
"number": "1467069260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1510 KONA PL",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954038605",
"telephone_number": "269-953-8899"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1510 KONA PL",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954038605",
"telephone_number": "269-953-8899"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELTRAN DEL RIO",
"first_name": "MARISA",
"middle_name": "LYNN",
"credential": "CMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-25",
"last_updated": "2020-09-25",
"certification_date": "2020-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "80433",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CMTA",
"identifier": "80433",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.