Healthcare Provider Details
I. General information
NPI: 1629747670
Provider Name (Legal Business Name): STEPPING INTO WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/12/2021
Last Update Date: 09/12/2021
Certification Date: 09/12/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4408 MARKET ST UNIT H
OAKLAND CA
94608-3455
US
IV. Provider business mailing address
3247 SYLVAN AVE
OAKLAND CA
94602-3957
US
V. Phone/Fax
- Phone: 510-274-1275
- Fax:
- Phone: 415-336-4036
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JAMIE
BENDER
Title or Position: CEO
Credential: LAC, DAOM
Phone: 415-336-4036