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

Nicholas Lazzaro

Individual provider Physical Therapist · NPI 1699557736

Nicholas Lazzaro is a Physical Therapist in Private Practice in Pismo Beach, California. Qualified in 2023, 3 years ago. Licensed in California.

Years since qualifying
3
Licensed in
CA
In the registry since
2023
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Practice location Address checks out

533 Five Cities Dr Ste C6
Pismo Beach, CA 93449-3006
Phone: (805) 489-7912
Fax: (805) 489-9697
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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 PT307438 (CA)

Record details

NPI number1699557736
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 13, 2023
Last updated in NPPESApril 15, 2025
Certification dateApril 15, 2025
Mailing address408 Higuera St Ste 200, San Luis Obispo, CA 93401-6135

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Accepts Medicare assignment Not indicated

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