Healthcare Provider Details

I. General information

NPI: 1356269930
Provider Name (Legal Business Name): JENIFER STONE MASSAGE THERAPIST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 N 2ND AVE
OAKDALE CA
95361-3029
US

IV. Provider business mailing address

214 CHURCH ST
MODESTO CA
95357-0212
US

V. Phone/Fax

Practice location:
  • Phone: 682-808-8708
  • Fax:
Mailing address:
  • Phone: 682-808-8708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: