Healthcare Provider Details

I. General information

NPI: 1134704034
Provider Name (Legal Business Name): MARSHELLA SMOTHERS LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23986 ALISO CREEK RD # 507
LAGUNA NIGUEL CA
92677-3908
US

IV. Provider business mailing address

23986 ALISO CREEK RD # 507
LAGUNA NIGUEL CA
92677-3908
US

V. Phone/Fax

Practice location:
  • Phone: 480-447-6445
  • Fax:
Mailing address:
  • Phone: 480-447-6445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number93714
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: