Active NPI
Maya Dickerson, PTA
- Physical Therapy Assistant
- Rancho Murieta, CA
National Provider Identifier
1699653352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 52476
- Practice address
- 7281 Lone Pine Dr Ste D103-a
Rancho Murieta, CA 95683-9715 - Phone
- (916) 354-0719
- NPI assigned
- Aug 21, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 52476 | CA | Primary |
Addresses
Primary practice location
7281 Lone Pine Dr Ste D103-a
Rancho Murieta, CA 95683-9715
Mailing address
8635 Carlin Ave
Sacramento, CA 95823-6931
Phone (916) 213-7958
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
| License | State | Type | Specialty |
|---|---|---|---|
| 52476 | CA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1755734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755734400000",
"number": "1699653352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8635 CARLIN AVE",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958236931",
"telephone_number": "916-213-7958",
"fax_number": "916-213-7958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7281 LONE PINE DR STE D103-A",
"city": "RANCHO MURIETA",
"state": "CA",
"postal_code": "956839715",
"telephone_number": "916-354-0719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DICKERSON",
"first_name": "MAYA",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-21",
"last_updated": "2025-08-21",
"certification_date": "2025-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "CA",
"license": "52476",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Murieta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.