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

Mrs. Amy Lack, MOT

Individual provider Occupational Therapist · NPI 1053814137

Mrs. Amy Lack, MOT is an Occupational Therapist in Private Practice in LA Mesa, California. Qualified in 2024, 2 years ago. Practices with Rise Physical Therapy Inc, a 58-clinician group. Licensed in California.

Years since qualifying
2
Licensed in
CA
In the registry since
2018
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Practice location Address checks out

7862 El Cajon Blvd
LA Mesa, CA 91942-6712
Phone: (619) 647-6157
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 27358 (CA)

Record details

NPI number1053814137
Entity typeIndividual (Type 1)
GenderFemale
Credentials MOT
Sole proprietorNo
NPI enumeratedMarch 14, 2018
Last updated in NPPESJanuary 19, 2026
Certification dateJanuary 19, 2026

Medicare enrollment

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

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Rise Physical Therapy Inc — 58 clinicians
Accepts Medicare assignment Not indicated

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