Individual provider Active NPI

Sherine Madilane Manalo-Brosas, R.P.T.

  • Physical Therapist
  • Fontana, CA
National Provider Identifier
1679753743
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27336 Issued in CA
Practice address
11231 Snow Bell PL
Fontana, CA 92337-6864
Phone
(909) 429-0801
NPI assigned
Nov 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 27336 CA Primary

Addresses

Primary practice location

11231 Snow Bell PL
Fontana, CA 92337-6864

Mailing address

11231 Snow Bell PL
Fontana, CA 92337-6864
Phone (909) 429-0801

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
27336CAMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Jamaica Physical Therapy, P.C. Physical Therapist PastSince Jun 18, 1998 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1679753743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11231 SNOW BELL PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923376864",
            "telephone_number": "909-429-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11231 SNOW BELL PL",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923376864",
            "telephone_number": "909-429-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANALO-BROSAS",
        "first_name": "SHERINE",
        "middle_name": "MADILANE",
        "name_prefix": "Mrs.",
        "credential": "R.P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "27336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fontana, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 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.