Healthcare Provider Details

I. General information

NPI: 1396481404
Provider Name (Legal Business Name): NESVE YAYALAR MASSAGE THERAPY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2022
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 ROCKY KNL
IRVINE CA
92612-3209
US

IV. Provider business mailing address

5 ROCKY KNL
IRVINE CA
92612-3209
US

V. Phone/Fax

Practice location:
  • Phone: 949-232-7296
  • Fax:
Mailing address:
  • Phone: 949-232-7296
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number76489
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: