Active NPI
Rachel Lucas
- Pediatric Physical Therapist
- San Mateo, CA
National Provider Identifier
1720532138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 291750
- Practice address
- 1650 S Amphlett Blvd
#108
San Mateo, CA 94402-2517 - Phone
- (650) 638-9142
- NPI assigned
- Aug 15, 2016
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 291750 | CA | Primary |
Addresses
Primary practice location
1650 S Amphlett Blvd
#108
San Mateo, CA 94402-2517
Mailing address
1831 San Luis Dr
San Luis Obispo, CA 93401-2621
Phone (805) 441-2354
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 |
|---|---|---|---|
| 291750 | CA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471219200000",
"number": "1720532138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1831 SAN LUIS DR",
"city": "SAN LUIS OBISPO",
"state": "CA",
"postal_code": "934012621",
"telephone_number": "805-441-2354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1650 S AMPHLETT BLVD",
"address_2": "#108",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944022517",
"telephone_number": "650-638-9142"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "RACHEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-15",
"last_updated": "2016-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "CA",
"license": "291750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.