Fahrial Licudo, PT, DPT
NPI 1952100430 · Physical Therapist · San Jose, CA
Enrolled with Medicare as Practitioner - Physical Therapist in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Fahrial Licudo, PT, DPT is a Physical Therapist provider in San Jose, CA (NPI 1952100430).
Provider details
- NPI number
- 1952100430
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT, DPT
- Sex
- Female
- Sole proprietor
- No
- License
- 307105 (CA)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2025-03-10
- Last updated
- 2025-03-10
- Certified
- 2025-03-09
Frequently asked questions
- What is Fahrial Licudo's NPI number?
- Fahrial Licudo's National Provider Identifier (NPI) is 1952100430, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Fahrial Licudo's specialty?
- Fahrial Licudo is listed in the NPPES registry with a primary specialty of Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Fahrial Licudo located?
- Fahrial Licudo's practice location on file with NPPES is 250 Hospital Pkwy, San Jose, CA 95119-1103.
- What is Fahrial Licudo's phone number?
- The practice phone number listed in the NPPES registry for Fahrial Licudo is (408) 972-3000.
- Does Fahrial Licudo accept Medicare?
- Fahrial Licudo is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Fahrial Licudo's NPI active?
- Yes — Fahrial Licudo's NPI (1952100430) is active in the NPPES registry as of the last update on 2025-03-10.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.