Essential Balance Physical Therapy, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ESSENTIAL BALANCE PHYSICAL THERAPY, INC

Practice address

25 Mitchell Blvd
Suite 2
San Rafael, CA 94903-2007

Phone

(415) 924-5700

Fax

(415) 924-5723

NPI assigned

May 20, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Bonnie Jean Davidson, PT

Title

Owner/Treasurer

Phone

(415) 924-5700

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yvonne Desarea Liebig, PT

  • Physical Therapist
  • Corte Madera, CA
  • NPI 1215224258
  NPD (past)
• Ha Thanh Trinh, DPT

  • Specialist
  • South San Francisco, CA
  • NPI 1275570491
  NPD (past)

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512432000000",
    "number": "1770537235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 MITCHELL BLVD",
            "address_2": "SUITE 2",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032007",
            "telephone_number": "415-924-5700",
            "fax_number": "415-924-5723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 MITCHELL BLVD",
            "address_2": "SUITE 2",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032007",
            "telephone_number": "415-924-5700",
            "fax_number": "415-924-5723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIAL BALANCE PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2017-12-05",
        "status": "A",
        "authorized_official_last_name": "DAVIDSON",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/TREASURER",
        "authorized_official_telephone_number": "415-924-5700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1609826965",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1205886561",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Iliana Maria Escudero Garcia
• James D. Eskridge, NP
• Raul Espino Blanco
• Alyssa Espinoza
• Essensuate Psychology Group, Apc
• Essential Life Family Therapy, Inc.
• Francis James Philip Estep
• Erick Estrada, RDH
• Fatima Estrada
• Kim Michelle Estrada, MA

• Physical Therapist in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2017; 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.