Individual provider Active NPI

Dorian Vincent de Paule

  • Physical Therapy Assistant
  • Lakeport, CA
National Provider Identifier
1275415622
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
48342 Issued in CA
Practice address
925 Bevins CT
Lakeport, CA 95453-9754
Phone
(707) 263-8382
NPI assigned
Jul 24, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 48342 CA Primary

Addresses

Primary practice location

925 Bevins CT
Lakeport, CA 95453-9754

Mailing address

PO Box 2402
Willits, CA 95490-2402
Phone (707) 513-7226

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)
Not enrolled

Interoperability endpoints

  • Direct secure messaging: dorian.vincentdepaule.p1@direct.lcthc.nextgenshare.com

NPI Registry JSON

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

{
    "created_epoch": "1753315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1275415622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2402",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954902402",
            "telephone_number": "707-513-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BEVINS CT",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954539754",
            "telephone_number": "707-263-8382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINCENT DE PAULE",
        "first_name": "DORIAN",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-07-24",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "48342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeport, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.