Lucie Taba, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

293527 Issued in CA

Practice address

224 Weller St
Petaluma, CA 94952-3136

Phone

(707) 762-7678

NPI assigned

Sep 15, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: lucie.madonick.1@26052.direct.athenahealth.com

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1295254654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888A PETALUMA BLVD S",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949525135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 WELLER ST",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949523136",
            "telephone_number": "707-762-7678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABA",
        "first_name": "LUCIE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Petaluma, CA
• Providers in Petaluma, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; 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.