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

Tyler Bouchard

Individual provider Physical Therapy Assistant · NPI 1649887076

Tyler Bouchard is a Physical Therapy Assistant in Davis, California. Licensed in California. Registered with an NPI since 2020.

Licensed in
CA
In the registry since
2020
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Practice location Address checks out

1515 Shasta Dr
Davis, CA 95616-6691
Phone: (707) 803-3156
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA50692 (CA)

Record details

NPI number1649887076
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 29, 2020
Last updated in NPPESSeptember 29, 2020
Certification dateSeptember 29, 2020
Mailing address4560 Se International Way Ste 100, Milwaukie, OR 97222-4628

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