Healthcare Provider Details

I. General information

NPI: 1629928973
Provider Name (Legal Business Name): CHERYL MANANSALA PRYOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 N PEACH AVE
CLOVIS CA
93611-7247
US

IV. Provider business mailing address

PO BOX 4044
CLOVIS CA
93613-4044
US

V. Phone/Fax

Practice location:
  • Phone: 559-872-8584
  • Fax:
Mailing address:
  • Phone: 660-234-4472
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number93451
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: