Lucinda Weaver I, M.P.T.
Physical Therapist, Orthopedic in Gualala, CA. Individual provider (NPI-1).
NPI number1184862013
StatusActive
Last updated in NPPESOct 16, 2020
Details
- NPI
- 1184862013
- Entity type
- Individual (NPI-1)
- Name
- Ms. Lucinda Weaver I
- Credential
- M.P.T.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 30, 2009
- Certification date
- Oct 15, 2020
- Last updated
- Oct 16, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251X0800X | Physical Therapist, Orthopedic | PT20541 | CA | Yes |
| 2251S0007X | Physical Therapist, Sports | 014743-1 | NY | |
| 2251S0007X | Physical Therapist, Sports | PT20541 | CA | |
| 2251X0800X | Physical Therapist, Orthopedic | 014743-1 | NY |
Practice location
39120 Ocean Dr.Gualala, CA 95445
Phone 707-884-4800 · Fax 707-884-4808
Mailing address
Po Box 1441Gualala, CA 95445-1441
Phone 707-884-4800 · Fax 707-884-4808
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