Healthcare Provider Details

I. General information

NPI: 1740166032
Provider Name (Legal Business Name): LILY PREKASKI PT, DPT, CSCS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1162B GORGAS AVE
SAN FRANCISCO CA
94129-1406
US

IV. Provider business mailing address

1162B GORGAS AVE
SAN FRANCISCO CA
94129-1406
US

V. Phone/Fax

Practice location:
  • Phone: 415-561-6655
  • Fax:
Mailing address:
  • Phone: 415-561-6655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number308592
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: