Individual provider Active NPI

Marlaina B Vance

  • Physical Therapist
  • Campbell, CA
National Provider Identifier
1700023389
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT291608 Issued in CA
Practice address
201 E Hamilton Ave
Campbell, CA 95008-0206
Phone
(408) 376-0900
NPI assigned
Jan 19, 2009
Last updated
Aug 22, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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 PT291608 CA Primary

Addresses

Primary practice location

201 E Hamilton Ave
Campbell, CA 95008-0206

Mailing address

201 E Hamilton Ave
Campbell, CA 95008-0206
Phone (408) 376-0900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160906000302 CA Practitioner - Physical Therapist in Private Practice 2567595549 Reassigns benefits to 1 organization
I20220420000539 AZ Practitioner - Physical Therapist in Private Practice 2567595549 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2580 Hwy 95
Suite 213
Bullhead City, AZ 86442-7331
Phone (281) 614-9400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT291608CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wecare Rehab Services Inc Physical Therapist CurrentSince Mar 1, 2017 Accepting new patients
MFR Physical Therapy LLC Physical Therapist CurrentSince Nov 16, 2021 Accepting new patients
Northern Arizona Physical Therapy Associates Physical Therapist PastSince Jun 3, 2025 Accepting new patients

Locations

2580 Highway 95
Ste 213
Bullhead City, AZ 86442
Phone (281) 614-9400

1895 Mowry Ave
Ste 118A
Fremont, CA 94538
Phone (510) 760-0383

27200 Calaroga Ave
Hayward, CA 94545
Phone (510) 264-2000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471824000000",
    "number": "1700023389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E HAMILTON AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080206",
            "telephone_number": "408-376-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E HAMILTON AVE",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950080206",
            "telephone_number": "408-376-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANCE",
        "first_name": "MARLAINA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-19",
        "last_updated": "2016-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT291608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.