Individual provider Active NPI

Lauren Tucker, LMT, MLD-C, CLT

  • Massage Therapist
  • Lake Elsinore, CA
National Provider Identifier
1346019155
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
94640 Issued in CA
Practice address
31569 Canyon Estates Dr Ste 109
Lake Elsinore, CA 92532-0470
Phone
(351) 399-0019
Fax
(951) 399-0021
NPI assigned
Dec 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 94640 CA
Massage Therapist 225700000X 94640 CA Primary

Addresses

Primary practice location

31569 Canyon Estates Dr Ste 109
Lake Elsinore, CA 92532-0470

Mailing address

35858 Octopus LN
Wildomar, CA 92595-8095
Phone (702) 334-7631

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

State licenses

LicenseStateTypeSpecialty
94640CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Socal Ritual Bodywork Single Specialty CurrentSince Feb 1, 2024 Accepting new patients

Locations

31569 Canyon Estates Dr
Ste 109
Lake Elsinore, CA 92532
Phone (351) 399-0019

40555 California Oaks Rd
Ste 118
Murrieta, CA 92562

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1346019155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35858 OCTOPUS LN",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925958095",
            "telephone_number": "702-334-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31569 CANYON ESTATES DR STE 109",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925320470",
            "telephone_number": "351-399-0019",
            "fax_number": "951-399-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "LAUREN",
        "credential": "LMT, MLD-C, CLT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "94640",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "94640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.