Healthcare Provider Details

I. General information

NPI: 1629524418
Provider Name (Legal Business Name): SHEILA ROCHELLE PAIGE MASSAGE THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2016
Last Update Date: 08/31/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1613 W. 70TH ST.
LOS ANGELES CA
90047-1931
US

IV. Provider business mailing address

1613 W 70TH ST
LOS ANGELES CA
90047-1931
US

V. Phone/Fax

Practice location:
  • Phone: 323-891-2983
  • Fax:
Mailing address:
  • Phone: 323-891-2983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175L00000X
TaxonomyHomeopath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: