NPIMap

Organization Active NPI

Vitality FRP Multidisciplinary Psychology and Physiotherapy for Chroni

  • Clinical Psychologist
  • Roseville, CA
National Provider Identifier
1831621291
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY21758 Issued in CA
Legal business name
VITALITY FRP MULTIDISCIPLINARY PSYCHOLOGY AND PHYSIOTHERAPY FOR CHRONI
Practice address
1650 Lead Hill Blvd
Roseville, CA 95661-3061
Phone
(510) 967-2474
NPI assigned
Apr 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Authorized official

Name
Heather Martarella
Title
President
Phone
(510) 967-2474

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X PSY21758 CA Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT19666 CA

Addresses

Primary practice location

1650 Lead Hill Blvd
Roseville, CA 95661-3061

Mailing address

1640 Ainsdale Dr
Roseville, CA 95747-5838

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1831621291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 AINSDALE DR",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957475838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 LEAD HILL BLVD",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613061",
            "telephone_number": "510-967-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALITY FRP MULTIDISCIPLINARY PSYCHOLOGY AND PHYSIOTHERAPY FOR CHRONI",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-03",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "MARTARELLA",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "510-967-2474"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY21758",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT19666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.