Provider Demographics
NPI:1932810918
Name:ALLINGTON, LISA DIANE CUCCIA (MPT)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:DIANE CUCCIA
Last Name:ALLINGTON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MISS
Other - First Name:LISA
Other - Middle Name:DIANE
Other - Last Name:CUCCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:2100 STONEBROOK CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95603-9057
Mailing Address - Country:US
Mailing Address - Phone:951-235-7323
Mailing Address - Fax:
Practice Address - Street 1:696 WHITING ST
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95945-7543
Practice Address - Country:US
Practice Address - Phone:530-777-5605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-09
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20295225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist