Healthcare Provider Details

I. General information

NPI: 1013040955
Provider Name (Legal Business Name): ANDREA MARR DUFFEY PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2698 IMPERIAL WAY
YUBA CITY CA
95993-9302
US

IV. Provider business mailing address

2698 IMPERIAL WAY
YUBA CITY CA
95993-9302
US

V. Phone/Fax

Practice location:
  • Phone: 530-933-9406
  • Fax:
Mailing address:
  • Phone: 530-933-9406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberA2876
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberAT 8563
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2306601534
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: