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General NPI Number Information
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NPI Number | 1083569743
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Entity Type | Individual
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Provider Name | BENEDICT LAGASCA PTA
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Gender | Male
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Dates
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Enumeration Date | 02/27/2026
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Last Update Date | 02/27/2026
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Provider Practice Location Address
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Address Line | 3410 INDUSTRIAL BLVD STE 102
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-5005
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Country | US
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Telephone | 916-669-9038
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Fax | 916-529-4161
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Provider Business Mailing Address
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Address Line | 5220 FITZWILLIAM WAY
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City | SACRAMENTO
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State | CA
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Zip | 95823-4122
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Country | US
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Telephone | 916-669-9038
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Fax | 916-529-4161
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 54660
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License Number State | CA
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