Marisa Fong

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

302703 Issued in CA

Practice address

2315 Stockton Blvd
North Addition Office Building Room 4212
Sacramento, CA 95817

Phone

(916) 734-7040

NPI assigned

May 9, 2023

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1683590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683590400000",
    "number": "1750071189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 STARGLOW CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958312733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 STOCKTON BLVD",
            "address_2": "NORTH ADDITION OFFICE BUILDING ROOM 4212",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95817",
            "telephone_number": "916-734-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONG",
        "first_name": "MARISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-09",
        "last_updated": "2023-05-09",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latisha Antoinette Fong
• Leslie Thomas Fong, D.D.S.
• Lindsay Michelle Fong, D.M.D.
• Makenzie Fong, MS
• Manchiem Sherry Fong
• Matthew Charles Fong, OD
• Melissa Jane Fong, DDS
• Morgan Fong
• Nicholas Fong
• Patricia F Fong, DDS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.