Healthcare Provider Details

I. General information

NPI: 1639081557
Provider Name (Legal Business Name): TUCKER PHYSICAL THERAPY & WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5328 STATE AVE
SACRAMENTO CA
95819-1738
US

IV. Provider business mailing address

5328 STATE AVE
SACRAMENTO CA
95819-1738
US

V. Phone/Fax

Practice location:
  • Phone: 831-359-8779
  • Fax:
Mailing address:
  • Phone: 831-359-8779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ERIN TUCKER
Title or Position: DIRECTOR
Credential: PT, DPT
Phone: 831-359-8779