Provider Demographics
NPI:1275516080
Name:MCCARTHY, LISE ELLEN (PT, DPT, GCS)
Entity Type:Individual
Prefix:DR
First Name:LISE
Middle Name:ELLEN
Last Name:MCCARTHY
Suffix:
Gender:F
Credentials:PT, DPT, GCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:927 VICENTE ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94116-3023
Mailing Address - Country:US
Mailing Address - Phone:415-665-4953
Mailing Address - Fax:415-665-4953
Practice Address - Street 1:1500 OWENS ST STE 400
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94158-2335
Practice Address - Country:US
Practice Address - Phone:415-665-4953
Practice Address - Fax:415-665-4953
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-25
Last Update Date:2023-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA252702251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics