Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Deandre Medlock, PTA

Individual provider Physical Therapist · NPI 1306770490

Deandre Medlock, PTA is a Physical Therapist in Placerville, California. Licensed in California. Registered with an NPI since 2026.

Licensed in
CA
In the registry since
2026
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

4300 Golden Center Dr Ste B
Placerville, CA 95667-6278
Phone: (530) 344-2045
Fax: (530) 642-0794
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 53465 (CA)

Record details

NPI number1306770490
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedJune 11, 2026
Last updated in NPPESJune 11, 2026
Certification dateJune 11, 2026
Mailing address4304 Deergrass St, Rancho Cordova, CA 95742-8278

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