| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MARY NELLY GERONIMO NAVARRETE | 1972072478 | 2018-11-14 |
Mary Nelly Geronimo [F] graduated in 2018 and primarily specializes in Physical Therapy.
Mary Nelly Geronimo Navarrete is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1972072478. Registration indicates Mary Nelly Geronimo Navarrete is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Physical Therapist (Physical Therapist, ) (Speech/Occupational/Physical Therapy/Chiropractor, ) (Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers)
| PECOS ID | 4385979509 |
| Entity Type | Individual |
| Provider Name | Mary Nelly Geronimo Navarrete DPT |
| Other Provider Name | Mary Nelly Geronimo |
| Practice Office Address | 137 E THOUSAND OAKS BLVD THOUSAND OAKS, CA US |
| Practice Office Telephone | 8053792132 |
| Practice Office Fax | 8059174206 |
| Mailing Address | 5720 RALSTON ST STE 200 VENTURA, CA 930037844 US |
| Business Telephone | 8058044168 |
| Business Fax | 8058301177 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 3109 Meadowstone Dr | Simi Valley, CA 930632189 | 6193160321 |
| 31248 Oak Crest Dr Ste 120 | Westlake Village, CA 913615673 | 8189269057 |
| 463 Pennsfield Pl Ste 103 | Thousand Oaks, CA 913605571 | 8052333800 |
| CONNECT URL [] | https://venturaortho.com/ | |
| CONNECT URL [] | venturaortho.com |
| Code | Practice | License No State |
|---|---|---|
| 225100000X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Physical Therapist Physical Therapist Speech/Occupational/Physical Therapy/Chiropractor Physical Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers | 295962
CA |
| 295962 | OTHER | CA | STATE LICENSE |