Healthcare Provider Details

I. General information

NPI: 1275615940
Provider Name (Legal Business Name): LAUREN DANIELLE MASI MPT, OCS, ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 01/31/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

380 CIVIC DR STE 100
PLEASANT HILL CA
94523-1946
US

IV. Provider business mailing address

380 CIVIC DR STE 100
PLEASANT HILL CA
94523-1946
US

V. Phone/Fax

Practice location:
  • Phone: 818-943-7480
  • Fax: 855-814-4495
Mailing address:
  • Phone: 818-943-7480
  • Fax: 855-814-4495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number048787
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License NumberPT33179
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2251E1300X
TaxonomyClinical Electrophysiology Physical Therapist
License Number048787
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT33179
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: