Olga Borovic Benardo

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501003605 Issued in MI

Practice address

14 Eden Valley CT
Colfax, CA 95713-9125

Phone

(408) 889-3829

NPI assigned

May 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1629635966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 N 35TH ST",
            "city": "GALESBURG",
            "state": "MI",
            "postal_code": "490539761",
            "telephone_number": "408-889-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 EDEN VALLEY CT",
            "city": "COLFAX",
            "state": "CA",
            "postal_code": "957139125",
            "telephone_number": "408-889-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENARDO",
        "first_name": "OLGA",
        "middle_name": "BOROVIC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501003605",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NV",
            "license": "6331",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aci-Standards, LLC
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• Dawn M Anderson, D.D.S.
• Auburn Eye Care Associates
• Daniel Alan Belajic, OD
• Arthur Carl Bern Jr., LVN
• Gloria Marie Bertacchi
• Bravemind Counseling, Licensed Clinical Social Worker Corporation
• Aeneas Chance, PHARM.D.
• Colfax Drug Company, LLC

• Physical Therapist in Colfax, CA
• Providers in Colfax, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 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.