Healthcare Provider Details

I. General information

NPI: 1306760822
Provider Name (Legal Business Name): NEIRA YASMIN VINES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11022 NEW ST STE 6
DOWNEY CA
90241-3715
US

IV. Provider business mailing address

10729 SHELLYFIELD RD
DOWNEY CA
90241-2818
US

V. Phone/Fax

Practice location:
  • Phone: 323-321-3272
  • Fax:
Mailing address:
  • Phone: 323-321-3272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number97165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: