Provider Demographics
NPI:1134401706
Name:MCCOOL, ERICA LINDSAY (DPT)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:LINDSAY
Last Name:MCCOOL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:716 STONEHURST DR
Mailing Address - Street 2:
Mailing Address - City:ALTADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91001-5338
Mailing Address - Country:US
Mailing Address - Phone:708-670-2170
Mailing Address - Fax:
Practice Address - Street 1:716 STONEHURST DR
Practice Address - Street 2:
Practice Address - City:ALTADENA
Practice Address - State:CA
Practice Address - Zip Code:91001-5338
Practice Address - Country:US
Practice Address - Phone:708-670-2170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-09
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist