MEDICARE: LAURA SIQUIG

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1558228510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA SIQUIG

Provider Business Mailing Address
First Line	:	PO BOX 453
Second Line	:
City	:	HAUULA
State	:	HI
Zip	:	96717-0453
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2910 MCCLURE ST
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94609-3505
Country	:	US
Telephone Number	:	510-836-3677
Fax Number	:

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

Provider Enumeration Date	:	01/09/2026
Last Update Date	:	01/09/2026

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Directions to “ LAURA SIQUIG ” Practice Location

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