Healthcare Provider Details

I. General information

NPI: 1194464230
Provider Name (Legal Business Name): DOWNLOAD WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1211 EMBARCADERO STE D
OAKLAND CA
94606-5117
US

IV. Provider business mailing address

1211 EMBARCADERO STE D
OAKLAND CA
94606-5117
US

V. Phone/Fax

Practice location:
  • Phone: 510-328-4098
  • Fax:
Mailing address:
  • Phone: 510-328-4098
  • 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: MS. SURMICHE VAUGHN
Title or Position: CMT
Credential:
Phone: 510-688-2919