Mary K Popylisen, PT, ATC
Specialist/Technologist, Athletic Trainer in Berkeley, CA. Individual provider (NPI-1).
NPI number1245441237
StatusActive
Last updated in NPPESSep 11, 2025
Details
- NPI
- 1245441237
- Entity type
- Individual (NPI-1)
- Name
- Mary K Popylisen
- Credential
- PT, ATC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 24, 2007
- Last updated
- Sep 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | 80680 | CA | Yes |
| 225100000X | Physical Therapist | 16912 | CA |
Practice location
2222 Bancroft ExtBerkeley, CA 94720-4300
Phone 510-642-5651 · Fax 510-643-5079
Mailing address
4436 Hyacinth AveOakland, CA 94619-2816
Phone 510-482-5510
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