Healthcare Provider Details

I. General information

NPI: 1265362917
Provider Name (Legal Business Name): LORA CHRISTEN PT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 OAK CT
MENLO PARK CA
94025-2841
US

IV. Provider business mailing address

304 OAK CT
MENLO PARK CA
94025-2841
US

V. Phone/Fax

Practice location:
  • Phone: 650-380-6878
  • Fax:
Mailing address:
  • Phone: 650-380-6878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number20069
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: