Individual provider Active NPI

Leanne Lundgren, PT

  • Physical Therapist
  • Oceanside, CA
National Provider Identifier
1013395417
Registry record updated Oct 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
42507 Issued in CA
Practice address
2122 S El Camino Real
#100
Oceanside, CA 92054-6208
Phone
(760) 681-5222
Fax
(760) 681-5151
NPI assigned
May 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 42507 CA Primary

Addresses

Primary practice location

2122 S El Camino Real
#100
Oceanside, CA 92054-6208

Mailing address

2122 S El Camino Real
#100
Oceanside, CA 92054-6208
Phone (760) 681-5222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42507CAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444262400000",
    "number": "1013395417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 S EL CAMINO REAL",
            "address_2": "#100",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546208",
            "telephone_number": "760-681-5222",
            "fax_number": "760-681-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2122 S EL CAMINO REAL",
            "address_2": "#100",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546208",
            "telephone_number": "760-681-5222",
            "fax_number": "760-681-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "LEANNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2015-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "42507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oceanside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.