Healthcare Provider Details

I. General information

NPI: 1649191289
Provider Name (Legal Business Name): KEISHA HARMON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

742 ARNOLD DR STE C
MARTINEZ CA
94553-6867
US

IV. Provider business mailing address

2174 MARSH AVE
PITTSBURG CA
94565-4740
US

V. Phone/Fax

Practice location:
  • Phone: 925-372-0700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number13723
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: