Individual provider · Type 1 NPI

Lacey Fogata

Physical Therapist · Corona, CA

NPI number 1912816240 Active

Practice location

2815 S Main St Ste 205
Corona, CA 92882-2533

Call (951) 475-1307 Map

Mailing address

4390 Jurupa Ave
Riverside, CA 92506-1766

Specialties and licenses

TaxonomyCodeLicense
Physical Therapist Primary 225100000X310996 (CA)

Physical Therapist: Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, r…

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About NPI 1912816240

Lacey Fogata's National Provider Identifier is 1912816240, issued on Sep 2, 2026. The primary taxonomy on file is Physical Therapist (225100000X), and the practice location is in Corona, CA. The record was last updated on Sep 16, 2026.