Healthcare Provider Details

I. General information

NPI: 1346045440
Provider Name (Legal Business Name): DYAMI KAPLAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2025
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 WARD ST
BERKELEY CA
94705-1027
US

IV. Provider business mailing address

2221 WARD ST
BERKELEY CA
94705-1027
US

V. Phone/Fax

Practice location:
  • Phone: 831-227-5396
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number78136
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: