Healthcare Provider Details

I. General information

NPI: 1548197668
Provider Name (Legal Business Name): ANASTASIA USOEVA CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 N SYCAMORE AVE APT 18
LOS ANGELES CA
90038-3301
US

IV. Provider business mailing address

725 N SYCAMORE AVE APT 18
LOS ANGELES CA
90038-3301
US

V. Phone/Fax

Practice location:
  • Phone: 310-593-1890
  • Fax:
Mailing address:
  • Phone: 310-593-1890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number97387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: