Active NPI
Nicole Larson, DPT
- Physical Therapist
- Livermore, CA
National Provider Identifier
1821566530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 295833
- Practice address
- 2492 Nissen Dr
Livermore, CA 94551-7704 - Phone
- (925) 980-8130
- NPI assigned
- Nov 12, 2018
- 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 Therapist | 225100000X | 295833 | CA | Primary |
Addresses
Primary practice location
2492 Nissen Dr
Livermore, CA 94551-7704
Mailing address
6759 Sierra CT Ste a
Dublin, CA 94568-2657
Phone (925) 803-0530
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
| License | State | Type | Specialty |
|---|---|---|---|
| 295833 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1541980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541980800000",
"number": "1821566530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6759 SIERRA CT STE A",
"city": "DUBLIN",
"state": "CA",
"postal_code": "945682657",
"telephone_number": "925-803-0530"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2492 NISSEN DR",
"city": "LIVERMORE",
"state": "CA",
"postal_code": "945517704",
"telephone_number": "925-980-8130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARSON",
"first_name": "NICOLE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-12",
"last_updated": "2018-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "295833",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livermore, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.