Healthcare Provider Details

I. General information

NPI: 1801351572
Provider Name (Legal Business Name): CHARLI HAMILTON CSCI, LMT, CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2019
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1181 37TH ST
SACRAMENTO CA
95816-5415
US

IV. Provider business mailing address

1181 37TH ST
SACRAMENTO CA
95816-5415
US

V. Phone/Fax

Practice location:
  • Phone: 206-800-1030
  • Fax:
Mailing address:
  • Phone: 206-800-1030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number102162
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: