Healthcare Provider Details

I. General information

NPI: 1952103491
Provider Name (Legal Business Name): ANASTASIYA A YUDINOVA CMP, M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 E ST STE 205
EUREKA CA
95501-0378
US

IV. Provider business mailing address

1349 MCFARLAN ST
EUREKA CA
95501-1344
US

V. Phone/Fax

Practice location:
  • Phone: 707-832-2929
  • Fax:
Mailing address:
  • Phone: 707-572-4842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number45623
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: