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NPI Code Detail

MEDICARE: DR. LISA THOMPSON DPT

MEDICARE:  DR. LISA  THOMPSON  DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist43030CA

General Provider Information

NPI Number : 1710356886
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LISA THOMPSON DPT
Provider Business Mailing Address
First Line : 1003 RIVER ST STE C
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-1754
Country : US
Telephone Number : 831-457-1800
Fax Number :
Provider Business Practice Location Address
First Line : 1003 RIVER ST STE C
Second Line :
City : SANTA CRUZ
State : CA
Zip : 95060-1754
Country : US
Telephone Number : 831-457-1800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2015
Last Update Date : 12/30/2021

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Directions to “ DR. LISA THOMPSON DPT” Practice Location

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