Healthcare Provider Details

I. General information

NPI: 1063383222
Provider Name (Legal Business Name): APOTHECARY ENERGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

730 I ST
SACRAMENTO CA
95814-2623
US

IV. Provider business mailing address

1026 FLORIN RD
SACRAMENTO CA
95831-3513
US

V. Phone/Fax

Practice location:
  • Phone: 916-296-7348
  • Fax:
Mailing address:
  • Phone: 916-296-7348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALISIA ANTONETTE MOORE
Title or Position: FOUNDER/STRATEGIST
Credential: LMT
Phone: 916-296-7348