Provider Demographics
NPI:1073585675
Name:WESTCOTT, LANCE STANLEY (PT)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:STANLEY
Last Name:WESTCOTT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-3603
Mailing Address - Country:US
Mailing Address - Phone:650-941-7600
Mailing Address - Fax:650-941-7603
Practice Address - Street 1:240 2ND ST
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-3603
Practice Address - Country:US
Practice Address - Phone:650-941-7600
Practice Address - Fax:650-941-7603
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-07
Last Update Date:2009-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28774225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT287741Medicare PIN