Lisa Bourbeau Mumford, P.T.

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

PT 20702 Issued in CA

Practice address

833 Broadway
Suite 100
El Cajon, CA 92021-4668

Phone

(619) 447-7774

NPI assigned

Feb 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Elnel, Inc. a California Corporation Total Physical Therapy

  • Physical Therapy Clinic/Center
  • Chula Vista, CA
  • NPI 1386681732

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1234742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234742400000",
    "number": "1730328600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 PEARL LAKE AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921193341",
            "telephone_number": "619-261-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "833 BROADWAY",
            "address_2": "SUITE 100",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920214668",
            "telephone_number": "619-447-7774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUMFORD",
        "first_name": "LISA",
        "middle_name": "BOURBEAU",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-16",
        "last_updated": "2009-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 20702",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "CA",
            "license": "PT 20702",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "PT 20702",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wayne Stanley Moyer, D.C. QME,IDE
• Rahmat M Moyinwin
• Mbuva Mpore-Carter
• Mutuhi Susan Mugo, M.D
• Joseph Michael Mullins, DDS, MS
• Violet Mundo
• Rusella Munguia-Torres
• Jorge Munoz
• Rhiannon M Munoz
• Jillian Muns

• Pediatric Physical Therapist in El Cajon, CA
• Providers in El Cajon, CA by specialty
• Pediatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2009; 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.