Blue Water Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT30454 Issued in CA

Legal business name

BLUE WATER PHYSICAL THERAPY

Practice address

2063 San Elijo Ave
Cardiff, CA 92007-1726

Phone

(714) 623-2035

NPI assigned

May 19, 2009

Organization subpart

No

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

Authorized official

Name

Mrs. Erin Renee Malecha, MPT

Title

Owner

Phone

(714) 623-2035

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristin Butterfield, MPT

  • Physical Therapist
  • Cardiff by the Sea, CA
  • NPI 1952648628
  NPD (past)

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422403200000",
    "number": "1942435045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2063 SAN ELIJO AVE",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920071726",
            "telephone_number": "714-623-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2063 SAN ELIJO AVE",
            "city": "CARDIFF",
            "state": "CA",
            "postal_code": "920071726",
            "telephone_number": "714-623-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE WATER PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2015-01-28",
        "status": "A",
        "authorized_official_last_name": "MALECHA",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-623-2035",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT30454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Gail Aiello, SUDCC
• Akasha Center Limited Liability Company
• Jenna Ryan Anderson, CD(DONA)
• Christina Colaianni Anthony, L.AC.
• Sera Bajaj
• Laura Anne Bowman
• Boyd-Olson Chiropractic
• Robin Leslie Boyd, D.C.
• Melissa Ann Browne
• Shane C Carpenter, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; 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.