Provider Demographics
NPI:1982414371
Name:TOMPKINS, LYANNA JANE MEDINA
Entity type:Individual
Prefix:
First Name:LYANNA JANE
Middle Name:MEDINA
Last Name:TOMPKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LYANNA
Other - Middle Name:
Other - Last Name:TOMPKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:908 GETOUN DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-3403
Mailing Address - Country:US
Mailing Address - Phone:925-300-6590
Mailing Address - Fax:
Practice Address - Street 1:101 BODIN CIR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94535-1809
Practice Address - Country:US
Practice Address - Phone:707-423-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist