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General NPI Number Information
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NPI Number | 1205850187
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Entity Type | Individual
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Provider Name | ANN M MARRACCINI P.T.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 02/20/2015
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Provider Practice Location Address
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Address Line | 860 VIA DE LA PAZ SUITE B1
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272
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Country | US
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Telephone | 310-573-9553
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Fax | 310-573-9533
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Provider Business Mailing Address
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Address Line | 860 VIA DE LA PAZ SUITE B1
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272
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Country | US
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Telephone | 310-573-9553
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Fax | 310-573-9533
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT00009032
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 39850
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License Number State | CA
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