Provider Demographics
NPI:1275615940
Name:MASI, LAUREN DANIELLE (MPT, OCS, ATC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:DANIELLE
Last Name:MASI
Suffix:
Gender:F
Credentials:MPT, OCS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:380 CIVIC DR STE 100
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-1946
Mailing Address - Country:US
Mailing Address - Phone:818-943-7480
Mailing Address - Fax:855-814-4495
Practice Address - Street 1:380 CIVIC DR STE 100
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-1946
Practice Address - Country:US
Practice Address - Phone:818-943-7480
Practice Address - Fax:855-814-4495
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048787225100000X, 2251E1300X
CAPT331792251E1300X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistElectrophysiology, Clinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY048787OtherNEW YORK STATE EDUCATION DEPARTMENT OFFICE OF THE PROFESSIONS
CAPT33179OtherLICENSE NUMBER