Individual provider Active NPI

Trina Gwendolyn Mann, DPT

  • Physical Therapist
  • Mill Valley, CA
National Provider Identifier
1730247347
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33356 Issued in CA
Practice address
23 Reed Blvd
Mill Valley, CA 94941-2301
Phone
(415) 383-1669
Fax
(414) 156-3413
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X
Physical Therapist 225100000X 33356 CA Primary

Addresses

Primary practice location

23 Reed Blvd
Mill Valley, CA 94941-2301

Mailing address

23 Reed Blvd
Mill Valley, CA 94941-2301
Phone (415) 383-1669

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
33356CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Change Sports Physical Therapy Institute Physical Therapist CurrentSince Sep 1, 2023 Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist Past Accepting new patients
Sport & Spine Therapy of Marin Inc Physical Therapist Past Accepting new patients
Agile Physical Therapy Inc PastSince Feb 14, 2022 Accepting new patients

Locations

6082 Edinger Ave
Ste 100
Huntington Beach, CA 92647
Phone (714) 840-1505

Organizations & group practices 4

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1730247347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 REED BLVD",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412301",
            "telephone_number": "415-383-1669",
            "fax_number": "415-634-1384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 REED BLVD",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412301",
            "telephone_number": "415-383-1669",
            "fax_number": "414-156-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "TRINA",
        "middle_name": "GWENDOLYN",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.