Liezl Sorianosos Arricivita, RPT, PTA
Individual provider Active NPI Physical Therapist · Lemoore, CA
NPI 1114230950 · NPPES record last updated Jul 21, 2010
Key facts
- NPI
- 1114230950
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 33949 (CA)
- Practice address
- 682 Avalon Dr
Lemoore, CA 93245-4382 - Phone
- (559) 978-8091
- NPI assigned
- Jul 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 33949 | CA | MD | Pharmacy Technician |
| AT8121 | CA | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 33949 | CA | Yes |
| Physical Therapy Assistant | 225200000X | AT8121 | CA |
Addresses
Primary practice location
682 Avalon Dr
Lemoore, CA 93245-4382
Mailing address
682 Avalon Dr
Lemoore, CA 93245-4382
Phone (559) 978-8091
Other providers in Lemoore, CA
- Paul Anthony Andre
- Aria Community Health Center
- Aria Community Health Center
- Aria Community Health Center
- Aria Community Health Center
- Scott J Ashby
- Victor Hugo Auld
- Avenal Community Health Center
- Samantha Crystal Avila
- Ray Avina
All providers in Lemoore, CA · Physical Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.