Healthcare Provider Details

I. General information

NPI: 1427982446
Provider Name (Legal Business Name): AUSTIN NENNEMAN CMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 ALHAMBRA BLVD STE 105
SACRAMENTO CA
95816-5237
US

IV. Provider business mailing address

701 PECAN ST APT B
WEST SACRAMENTO CA
95691-2568
US

V. Phone/Fax

Practice location:
  • Phone: 916-451-5552
  • Fax:
Mailing address:
  • Phone: 913-702-6060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number66895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: