Active NPI
Marybeth Vergara
- Physical Therapy Assistant
- Long Beach, CA
National Provider Identifier
1972969889
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 9472
- Practice address
- 3232 E Artesia Blvd
Long Beach, CA 90805-2811 - Phone
- (562) 422-9219
- NPI assigned
- Jan 7, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 9472 | CA | Primary |
Addresses
Primary practice location
3232 E Artesia Blvd
Long Beach, CA 90805-2811
Mailing address
4228 Obispo Ave
Lakewood, CA 90712-4025
Phone (562) 277-5080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9472 | CA | MD | Primary Care Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1452124800000",
"number": "1972969889",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4228 OBISPO AVE",
"city": "LAKEWOOD",
"state": "CA",
"postal_code": "907124025",
"telephone_number": "562-277-5080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3232 E ARTESIA BLVD",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908052811",
"telephone_number": "562-422-9219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERGARA",
"first_name": "MARYBETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-07",
"last_updated": "2016-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "9472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.