NPIMap

Organization Active NPI

Sebastopol Physical Therapy and Pilates Studio

  • Physical Therapist
  • Sebastopol, CA
National Provider Identifier
1538201546
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT13313 Issued in CA
Legal business name
SEBASTOPOL PHYSICAL THERAPY AND PILATES STUDIO
Practice address
100 Pleasant Hill Ave N
Sebastopol, CA 95472-3104
Phone
(707) 829-3282
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Patricia Donovan Martinez, P.T.NPI 1326180175
Title
Owner
Phone
(707) 829-3282

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT13313 CA Primary

Addresses

Primary practice location

100 Pleasant Hill Ave N
Sebastopol, CA 95472-3104

Mailing address

100 Pleasant Hill Ave N
Sebastopol, CA 95472-3104
Phone (707) 829-3282

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ07609ZOtherCABLUE SHIELD PROVIDER NUMB

National Provider Directory

National Provider Directory

Locations

100 Pleasant Hill Ave N
Sebastopol, CA 95472
Phone (707) 829-3282

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1538201546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PLEASANT HILL AVE N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723104",
            "telephone_number": "707-829-3282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PLEASANT HILL AVE N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723104",
            "telephone_number": "707-829-3282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEBASTOPOL PHYSICAL THERAPY AND PILATES STUDIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "DONOVAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "707-829-3282",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT13313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD PROVIDER NUMB",
            "identifier": "ZZZ07609Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; 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.