Laura Sydney Medina
Individual provider Active NPI Physical Therapy Assistant · Blue Jay, CA
NPI 1972496768 · NPPES record last updated May 30, 2025
Key facts
- NPI
- 1972496768
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 8171 (CA)
- Practice address
- 27169 Ca-189 Suite 2
Blue Jay, CA 92317 - Phone
- (909) 855-0861
- NPI assigned
- May 30, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8171 | CA | Yes |
Addresses
Primary practice location
27169 Ca-189 Suite 2
Blue Jay, CA 92317
Mailing address
PO Box 565
Rimforest, CA 92378-0565
Phone (909) 800-4488
Other providers in Blue Jay, CA
- Yun Nancy Lee
- Ruth E Lester
- Hans Ignatius Lim
- Nancy Campos Madero
- Richard Piedra Madero
- Pooja Mujumdar
- Nurses for Safe Access
- Nurses for Safe Access
- Pamela Perlmutter
- Meaghan Plooy
All providers in Blue Jay, CA · Physical Therapy Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.