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NPI Code Detail

MEDICARE: GAVIN STEPHEN SCARBROUGH-KIDD LMT

MEDICARE: GAVIN STEPHEN SCARBROUGH-KIDD LMT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMAT-17964HI

General Provider Information

NPI Number : 1477486785
Entity Type Code : Individual
Provider Name (Legal Business Name) : GAVIN STEPHEN SCARBROUGH-KIDD LMT
Provider Business Mailing Address
First Line : 3435 SILVERBELL RD
Second Line :
City : CHICO
State : CA
Zip : 95973-0386
Country : US
Telephone Number : 530-774-2261
Fax Number : 530-774-2378
Provider Business Practice Location Address
First Line : 3435 SILVERBELL RD
Second Line :
City : CHICO
State : CA
Zip : 95973-0386
Country : US
Telephone Number : 530-774-2261
Fax Number : 530-774-2378
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2026
Last Update Date : 06/05/2026

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