Marissa Leanne Eisengart, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

296190 Issued in CA

Practice address

2100 Solar Dr Ste 204
Oxnard, CA 93036-2602

Phone

(805) 765-4773

NPI assigned

Jan 29, 2019

Last updated

Jan 29, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548720000000",
    "number": "1679037113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 EVANS AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930013424",
            "telephone_number": "510-508-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 SOLAR DR STE 204",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930362602",
            "telephone_number": "805-765-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENGART",
        "first_name": "MARISSA",
        "middle_name": "LEANNE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "296190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elevated Intimacy, Inc., Licensed Clinical Social Worker Corporation

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2019; 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.