Healthcare Provider Details

I. General information

NPI: 1710813142
Provider Name (Legal Business Name): JOSEPH KALANI KANAEHOLO CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2908 G ST STE B
MERCED CA
95340-2106
US

IV. Provider business mailing address

1955 FALL BROOK CT
MERCED CA
95340-0758
US

V. Phone/Fax

Practice location:
  • Phone: 209-812-1448
  • Fax:
Mailing address:
  • Phone: 209-617-1423
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number101264
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: