Healthcare Provider Details

I. General information

NPI: 1063243152
Provider Name (Legal Business Name): CHAYANISA SINGHASEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2024
Last Update Date: 08/09/2024
Certification Date: 08/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 QUAIL ST STE 160
NEWPORT BEACH CA
92660-2721
US

IV. Provider business mailing address

17208 PINTADO
IRVINE CA
92618-0291
US

V. Phone/Fax

Practice location:
  • Phone: 949-353-3998
  • Fax:
Mailing address:
  • Phone: 949-353-3998
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: