Provider Demographics
NPI:1073741047
Name:ARILD, MARIANNE (PT, PA-C)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:ARILD
Suffix:
Gender:F
Credentials:PT, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 PROSPECT ROW
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-2324
Mailing Address - Country:US
Mailing Address - Phone:650-343-9133
Mailing Address - Fax:650-343-9133
Practice Address - Street 1:3441 ALMA ST
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-3506
Practice Address - Country:US
Practice Address - Phone:650-323-4440
Practice Address - Fax:650-323-4441
Is Sole Proprietor?:No
Enumeration Date:2009-06-29
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15683225100000X
CAPA21520363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant