Individual provider Active NPI

Lori Ann Yerian Dentinger, P.T.

  • Physical Therapist
  • Galt, CA
National Provider Identifier
1699815787
Registry record updated Feb 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT15530 Issued in CA
Practice address
835 C St Ste 130
Galt, CA 95632-2802
Phone
(209) 745-5802
Fax
(209) 745-5574
NPI assigned
Feb 7, 2007
Last updated
Feb 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT15530 CA Primary

Addresses

Primary practice location

835 C St Ste 130
Galt, CA 95632-2802

Mailing address

408 Higuera St Ste 200
San Luis Obispo, CA 93401-6135
Phone (805) 788-0805

Other identifiers 2

IdentifierTypeStateIssuer
PA0164OtherCAALTA CALIFORNIA REGIONAL
PT0015530OtherCAMEDI-CAL PROVIDER NUMBER

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
15530CAMDAcupuncturist
PT15530CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Hill Physical Therapy PC Physical Therapist CurrentSince Jul 1, 2013 Accepting new patients
Spring Hill Physical Therapy and Acupuncture Physical Therapist PastSince Jul 1, 2013 Accepting new patients

Locations

300 Sierra College Dr
Ste 165
Grass Valley, CA 95945
Phone (530) 274-2320

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1699815787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 HIGUERA ST STE 200",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016135",
            "telephone_number": "805-788-0805",
            "fax_number": "805-788-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "835 C ST STE 130",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956322802",
            "telephone_number": "209-745-5802",
            "fax_number": "209-745-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENTINGER",
        "first_name": "LORI",
        "middle_name": "ANN YERIAN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT15530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTA CALIFORNIA REGIONAL",
            "identifier": "PA0164",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER NUMBER",
            "identifier": "PT0015530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Galt, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; 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.