Healthcare Provider Details

I. General information

NPI: 1952195174
Provider Name (Legal Business Name): CORINNE COCCIA CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CORI COCCIA

II. Dates (important events)

Enumeration Date: 04/04/2025
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2424 SPAULDING AVE APT 10
BERKELEY CA
94703-1665
US

IV. Provider business mailing address

2424 SPAULDING AVE APT 10
BERKELEY CA
94703-1665
US

V. Phone/Fax

Practice location:
  • Phone: 415-686-3438
  • Fax:
Mailing address:
  • Phone: 415-686-3438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29771
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: