Healthcare Provider Details

I. General information

NPI: 1093648552
Provider Name (Legal Business Name): BELLA DORY JETT MALULANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 S COAST HWY STE D
OCEANSIDE CA
92054-5062
US

IV. Provider business mailing address

2338 HOGAN WAY
OCEANSIDE CA
92056-3711
US

V. Phone/Fax

Practice location:
  • Phone: 858-663-5966
  • Fax:
Mailing address:
  • Phone: 808-298-5635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9345
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: