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General NPI Number Information
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NPI Number | 1275516080
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Entity Type | Individual
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Provider Name | LISE ELLEN MCCARTHY PT, DPT, GCS
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Gender | Female
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Dates
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Enumeration Date | 11/25/2005
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Last Update Date | 03/21/2023
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Provider Practice Location Address
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Address Line | 1500 OWENS ST STE 400
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City | SAN FRANCISCO
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State | CA
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Zip | 94158-2335
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Country | US
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Telephone | 415-665-4953
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Fax | 415-665-4953
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Provider Business Mailing Address
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Address Line | 927 VICENTE ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-3023
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Country | US
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Telephone | 415-665-4953
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Fax | 415-665-4953
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | 25270
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License Number State | CA
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