Jenna Raquel Marshall

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT303678 Issued in CA

Practice address

2615 Pacific Coast Hwy Ste 120
Hermosa Beach, CA 90254-2285

Phone

(310) 933-3690

NPI assigned

Feb 24, 2023

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Evolution Physical Therapy IncGroup PAC ID 0244336964, 72 clinicians

Davis and Derosa Physical Therapy IncGroup PAC ID 7113954264, 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Davis and Derosa Physical Therapy, Inc

  • Physical Therapist
  • El Segundo, CA
  • NPI 1558414102
  Medicare reassignment Care Compare group NPD
• Evolution Physical Therapy, Inc

  • Physical Therapist
  • Culver City, CA
  • NPI 1174601116
  Medicare reassignment Care Compare group NPD
• Manhattan Beach Pacific Physical Therapy Inc

  • Physical Therapist
  • El Segundo, CA
  • NPI 1396799458
  Medicare reassignment NPD
• Next Phase Medical PC

  • General Practice Physician
  • Culver City, CA
  • NPI 1821961863
  NPD (past)

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

{
    "created_epoch": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1598464992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2903 JOHNSTON AVE",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902781515",
            "telephone_number": "310-490-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 PACIFIC COAST HWY STE 120",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902542285",
            "telephone_number": "310-933-3690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "JENNA",
        "middle_name": "RAQUEL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT303678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magie M. Malaro, MD
• Casey Manchester, MA CCC SLP
• Kelsey Mann, DPT, PT
• Marilisa Raju, PHD Psychologist, a Professional Corporation
• Alexis Ashley Maron, RDT, BCT
• Martha B. Koo, M.D., LTD.
• Kimberly Martins, M.A.
• Elizabeth H Marushin, MFT
• Mary Jo Ford MD Inc
• Steven Richard Mason, PSY.D. PSYCHOLOGIST

• Physical Therapist in Hermosa Beach, CA
• Providers in Hermosa Beach, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.