Healthcare Provider Details

I. General information

NPI: 1740192384
Provider Name (Legal Business Name): BRIAN MEUEL CMT
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 MAIN ST
FAIR OAKS CA
95628-7556
US

IV. Provider business mailing address

4150 MAIN ST
FAIR OAKS CA
95628-7556
US

V. Phone/Fax

Practice location:
  • Phone: 925-519-8894
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number103747
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: