Healthcare Provider Details

I. General information

NPI: 1851452015
Provider Name (Legal Business Name): JOY MARIE WICAL P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44303 LOWTREE AVE
LANCASTER CA
93534-4149
US

IV. Provider business mailing address

8328 W AVENUE E12
LANCASTER CA
93536-7012
US

V. Phone/Fax

Practice location:
  • Phone: 661-940-5494
  • Fax: 661-940-0825
Mailing address:
  • Phone: 661-728-0146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT 14761
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberLPT-33290
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: