Healthcare Provider Details

I. General information

NPI: 1831045392
Provider Name (Legal Business Name): LORIE ANISE GREER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2026
Last Update Date: 03/07/2026
Certification Date: 03/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5120 MANZANITA AVE STE 110
CARMICHAEL CA
95608-0590
US

IV. Provider business mailing address

2162 6TH AVE
SACRAMENTO CA
95818-4310
US

V. Phone/Fax

Practice location:
  • Phone: 916-926-0496
  • Fax:
Mailing address:
  • Phone: 530-710-3519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number51691
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: