RENEW PHYSICAL THERAPY PC (NPI# 1255508453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255508453 |
| Entity Type | Organization |
| Organization Name | RENEW PHYSICAL THERAPY PC |
| Practice Address |
1427 Grant Ave Novato CA 94945 |
| Mailing Address |
1427 Grant Ave Novato CA 94945-3118 |
| Practice Telephone | 4158951705 |
| Practice Fax Number | 4157076776 |
| Mailing Telephone | 4158956995 |
| Mailing Fax Number | 4157076776 |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2020-02-08 |
| Authorized Official Name | MR. STEPHEN MONGIELLO I (PHYSICAL THERAPIST/OWNER) |
| Authorized Official Telephone | 4153818707 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
23976 | CA | Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 460 Boulevard Way Ste 2d, Piedmont, CA 946101525 | 5109228872 | |
| 659 Commercial St Ste 101, San Francisco, CA 941112566 | ||
| 9909 Mira Mesa Blvd Ste 260, San Diego, CA 921311064 | 8583859400 | |
| 1427 Grant Ave, Novato, CA 94945 | 4158951705 | 4157076776 |
| 591 Redwood Hwy Frontage Rd Ste 2235, Mill Valley, CA 949416028 | 4153818707 | 4156346033 |
| 247 Shoreline Hwy, Suite A9, Mill Valley, CA 949413664 | 4153818707 | 4156346033 |
| Street Address |
1427 GRANT AVE |
| City | NOVATO |
| State | CA |
| Zip Code | 94945 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124639943 | Joseph Francis Bielefeld | Nurse Practitioner | Marinhealth, 75 Rowland Way, #230, Novato, CA 94945 | 2020-08-14 |
| 1255835203 | California Orthopedics & Spine Inc | Physical Therapist | 7100 Redwood Boulevard, Suite 200, Novato, CA 94945 | 2018-03-22 |
| 1932601648 | Dawn Cheree Holiday-bruner | Marriage & Family Therapist | 6965 Redwood Blvd, Novato, CA 94945 | 2018-03-08 |
| 1558789545 | Kristi Marie Hudson | Marriage & Family Therapist | 7250 Redwood Blvd., Suite 300, Novato, CA 94945 | 2014-04-07 |
| 1467738484 | Andrea E Lieberstein | Dietitian, Registered | 800 De Long Avenue, Suite 100, Novato, CA 94945 | 2011-10-24 |
| 1992954473 | Elizabeth Taryn Clark | Marriage & Family Therapist | 7250 Redwood Blvd Ste 320, Novato, CA 94945 | 2008-09-09 |
| 1407032824 | Richard P. Knudsen | Pediatrics | 100 Rowland Way, Suite 300, Pulmonary and Sleep Associates of Marin, Novato, CA 94945 | 2008-01-16 |
| 1528250735 | Susan Jean Arndt | Counselor | 505-a San Marin Drive Suite 150, Novato, CA 94945 | 2007-08-11 |
| 1588871735 | Margaret Carol Pappas | Registered Nurse | 1025 Fifth Street, Novato, CA 94945 | 2007-05-17 |
| 1396959201 | Kelly Maureen Ferrini | Nurse Practitioner | 1767 Grant Ave, Novato, CA 94945 | 2007-05-09 |
| Find all providers in zip 94945 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467051839 | The Pelvic Model Physical Therapy, Inc. | Clinic/Center | 3761 Vinton Ave Apt 6, Los Angeles, CA 90034-5781 | 2020-10-18 |
| 1932707957 | Body In Motion Therapy, P.c | Clinic/Center | 1111 S Grand Ave Apt 708, Los Angeles, CA 90015-2169 | 2020-10-12 |
| 1992303275 | Vw Physical Therapy, Inc. | Clinic/Center | 100 Saybrook Ave, Vacaville, CA 95687-4129 | 2020-10-09 |
| 1730787094 | Movement System Institute Physiotherapy Inc | Clinic/Center | 508 Glenwood Rd Apt 102, Glendale, CA 91202-1572 | 2020-10-09 |
| 1538766530 | Sterling King Physical Therapy | Clinic/Center | 1820 Fullerton Ave Ste 280, Corona, CA 92881-3175 | 2020-10-03 |
| 1902403041 | Jha Geriatric Services, Inc | Clinic/Center | 12490 Fielding Circle, Suite 174, Playa Vista, CA 90094-3024 | 2020-10-01 |
| 1245847540 | Bespoke San Diego Physical Therapy PC | Clinic/Center | 2748 Ariane Dr, Unit 141, San Diego, CA 92117-3407 | 2020-09-30 |
| 1285241786 | Rapid Recovery Physical Therapy Inc | Clinic/Center | 39807 Paseo Padre Pkwy, Fremont, CA 94538-2974 | 2020-09-28 |
| 1053928697 | Bonnie Laine Lasher | Clinic/Center | 33772 Copper Lantern St Apt C, Dana Point, CA 92629-6427 | 2020-09-28 |
| 1295340792 | Naum Physical Therapy PC | Clinic/Center | 11405 Fulbourn Ct, Rancho Cucamonga, CA 91730-8341 | 2020-09-10 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.