Active NPI
Lucas Ryan Vallee, PHYSICAL THERAPIST
- Physical Therapist
- Arcata, CA
National Provider Identifier
1841720463
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 36091
- Practice address
- 3800 Janes Rd
Arcata, CA 95521-4742 - Phone
- (707) 839-5905
- Fax
- (707) 839-5907
- NPI assigned
- Jun 15, 2017
- Sex
- Male
- 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 | 36091 | CA | Primary |
Addresses
Primary practice location
3800 Janes Rd
Arcata, CA 95521-4742
Mailing address
1650 Central Ave Ste a
McKinleyville, CA 95519-4389
Phone (707) 839-5905
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 |
|---|---|---|---|
| 36091 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497484800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1841720463",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 CENTRAL AVE STE A",
"city": "MCKINLEYVILLE",
"state": "CA",
"postal_code": "955194389",
"telephone_number": "707-839-5905",
"fax_number": "707-839-5907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3800 JANES RD",
"city": "ARCATA",
"state": "CA",
"postal_code": "955214742",
"telephone_number": "707-839-5905",
"fax_number": "707-839-5907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VALLEE",
"first_name": "LUCAS",
"middle_name": "RYAN",
"name_prefix": "Mr.",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-06-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "36091",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcata, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.