Individual provider Active NPI

Celina Noelle Fine, PA

  • Physician Assistant
  • Sausalito, CA
National Provider Identifier
1760265995
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
64030 Issued in CA
Practice address
100 Phillips Dr
Sausalito, CA 94965-1172
Phone
(415) 339-8813
Fax
(415) 339-8814
NPI assigned
Aug 14, 2023
Last updated
Sep 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 64030 CA Primary

Addresses

Primary practice location

100 Phillips Dr
Sausalito, CA 94965-1172

Mailing address

100 Phillips Dr
Sausalito, CA 94965-1172
Phone (415) 339-8813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240609000133 CA Practitioner - Physician Assistant 4587106315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Phillips Dr
Sausalito, CA 94965-1172
Phone (415) 339-8813

880 Las Gallinas Ave
Suite 2
San Rafael, CA 94903-3437
Phone (415) 339-8813

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
64030CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Marin City Health and Wellness Center CurrentSince Dec 22, 2024 Accepting new patients
Marin City Health and Wellness Center CurrentSince Dec 22, 2024 Accepting new patients

Locations

880 Las Gallinas Ave
Ste 2
San Rafael, CA 94903
Phone (415) 339-8813

100 Phillips Dr
Sausalito, CA 94965
Phone (415) 339-8813

630 Drake Ave
Sausalito, CA 94965
Phone (415) 339-8813

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1760265995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS DR",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651172",
            "telephone_number": "415-339-8813",
            "fax_number": "415-339-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS DR",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651172",
            "telephone_number": "415-339-8813",
            "fax_number": "415-339-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FINE",
        "first_name": "CELINA",
        "middle_name": "NOELLE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "64030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sausalito, CA

Sources for this page

Verify at the official NPI Registry.