=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831045392
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LORIE ANISE GREER
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2026
-----------------------------------------------------
Last Update Date | 03/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5120 MANZANITA AVE STE 110
-----------------------------------------------------
City | CARMICHAEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95608-0590
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-926-0496
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2162 6TH AVE
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95818-4310
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-710-3519
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | 51691
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------