Healthcare Provider Details

I. General information

NPI: 1932976008
Provider Name (Legal Business Name): AKARI TAKAHASHI CMT, CST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2023
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1394 PARK AVE
EMERYVILLE CA
94608-3537
US

IV. Provider business mailing address

1394 PARK AVE
EMERYVILLE CA
94608-3537
US

V. Phone/Fax

Practice location:
  • Phone: 310-427-9048
  • Fax:
Mailing address:
  • Phone: 310-427-9048
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number85677
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: