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

Kevin Daniel Lane, PT

Individual provider Physical Therapist · NPI 1124056536

Kevin Daniel Lane, PT is a Physical Therapist in Private Practice in Stockton, California. Qualified in 2005, 21 years ago. Practices with Golden Bear Physical Therapy Sports Injury Center Inc, a 83-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
21
Licensed in
CA
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

534 E Pine St Ste A
Stockton, CA 95204-5536
Phone: (209) 463-5800
Fax: (209) 463-5900
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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 PT20980 (CA)

Record details

NPI number1124056536
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorNo
NPI enumeratedJune 28, 2006
Last updated in NPPESApril 18, 2017

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Golden Bear Physical Therapy Sports Injury Center Inc — 83 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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