MEDICARE: MARIELLE MANALO VILLANUEVA OTR/L

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist	25961	CA

General Provider Information

NPI Number	:	1144082108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIELLE MANALO VILLANUEVA OTR/L

Provider Business Mailing Address
First Line	:	62 RIDGE AVE
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-3433
Country	:	US
Telephone Number	:	510-826-9866
Fax Number	:

Provider Business Practice Location Address
First Line	:	62 RIDGE AVE
Second Line	:
City	:	SAN RAFAEL
State	:	CA
Zip	:	94901-3433
Country	:	US
Telephone Number	:	510-826-9866
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2024
Last Update Date	:	01/25/2024

Similar Medicare Providers

1689782245 — DR. JAHANGIR SADEGHI M.D.
Practice Location Address:

950 NORTHGATE DR
SAN RAFAEL, CA
94903-3433

Practice Phone: 415-479-2372
Practice Fax: 415-472-6225

1902932734 — MERVYN R STEIN MD
Practice Location Address:

950 NORTHGATE DR , SUITE 209
SAN RAFAEL, CA
94903-3433

Practice Phone: 415-479-2372
Practice Fax: 415-472-6225

1164961934 — MATTHEW BEDELL MD INC.
Practice Location Address:

950 NORTHGATE DR STE 209
SAN RAFAEL, CA
94903-3433

Practice Phone: 415-461-5500
Practice Fax:

1215605530 — LOUIS YANG MD
Practice Location Address:

950 NORTHGATE DR STE 209
SAN RAFAEL, CA
94903-3433

Practice Phone: 415-479-2373
Practice Fax: 415-472-6225

1790643856 — KAILEY DINEEN DANIELS AMFT
Practice Location Address:

2525 WIGHTMAN ST
SAN DIEGO, CA
92104-3433

Practice Phone: 619-800-6292
Practice Fax:

1255343224 — CAROL MUELLE INC
Practice Location Address:

764 SAN ANTONIO DR NE
ATLANTA, GA
30306-3433

Practice Phone: 404-815-0022
Practice Fax: 404-748-1693

Directions to “ MARIELLE MANALO VILLANUEVA OTR/L” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.