Serena Detienne Roda, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT26281 Issued in CA

Practice address

1345 Park St
Paso Robles, CA 93446-2236

Phone

(805) 226-0975

Fax

(805) 226-0909

NPI assigned

Jun 30, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Serena Mae Detienne Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• CV Physical Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Stockton, CA
  • NPI 1811150311

  Physical Therapist

  NPD (past)
• San Luis Physical Therapy & Orthopedic Rehabilitation Inc

  • Physical Therapy Clinic/Center
  • Atascadero, CA
  • NPI 1225046824

  Physical Therapist

  NPD (past)
• Mountain Valley Therapy, Inc

  • Physical Therapist
  • La Grande, OR
  • NPI 1659353035
  NPD (past)

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1770511354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 WALNUT ST # 110",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012416",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 PARK ST",
            "city": "PASO ROBLES",
            "state": "CA",
            "postal_code": "934462236",
            "telephone_number": "805-226-0975",
            "fax_number": "805-226-0909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODA",
        "first_name": "SERENA",
        "middle_name": "DETIENNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT26281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SERENA",
            "last_name": "DETIENNE",
            "middle_name": "MAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Marylin B Ricardo-Ortiz, MD
• Arleada F Robertson, PA
• Robles Ranch Mental Health Inc
• Brady Robles, DDS
• Jason Aaron Roda, PT
• Lauren Rodrigues
• Hanna Chariz Roewer, FNP-BC
• Romayne T. Swanson O.D.
• Victor Romero, PT
• Kayla Dawn Roth, PHARMD

• Physical Therapist in Paso Robles, CA
• Providers in Paso Robles, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.