Healthcare Provider Details

I. General information

NPI: 1861333411
Provider Name (Legal Business Name): JOSE ERMER RAUDA-FRANCO CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

530 S LAKE AVE # 319
PASADENA CA
91101-3515
US

IV. Provider business mailing address

530 S LAKE AVE # 319
PASADENA CA
91101-3515
US

V. Phone/Fax

Practice location:
  • Phone: 310-560-4401
  • Fax:
Mailing address:
  • Phone: 310-560-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number99932
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: