Healthcare Provider Details

I. General information

NPI: 1003781980
Provider Name (Legal Business Name): NCEPT DIAGNOSTICS AND PHYSICAL THERAPY SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2025
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

457 N ELM ST
ESCONDIDO CA
92025-3001
US

IV. Provider business mailing address

457 N ELM ST
ESCONDIDO CA
92025-3001
US

V. Phone/Fax

Practice location:
  • Phone: 760-489-1969
  • Fax: 760-489-5226
Mailing address:
  • Phone: 760-489-1969
  • Fax: 760-489-5226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204R00000X
TaxonomyElectrodiagnostic Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: SKYE GRAYSON
Title or Position: OWNER
Credential: DPT
Phone: 760-489-1969