Healthcare Provider Details

I. General information

NPI: 1154236149
Provider Name (Legal Business Name): KNEADING RELAXATION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2026
Last Update Date: 08/15/2026
Certification Date: 08/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1588 S MISSION RD STE 220
FALLBROOK CA
92028-4112
US

IV. Provider business mailing address

1588 S MISSION RD STE 220
FALLBROOK CA
92028-4112
US

V. Phone/Fax

Practice location:
  • Phone: 760-960-4666
  • Fax:
Mailing address:
  • Phone: 760-960-4666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: TERESA JIMENEZ
Title or Position: OWNER
Credential: MT
Phone: 760-960-4666