Healthcare Provider Details

I. General information

NPI: 1689520827
Provider Name (Legal Business Name): JORIS TIRADO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2860 HARRISON ST
SAN FRANCISCO CA
94110-4117
US

IV. Provider business mailing address

2860 HARRISON ST
SAN FRANCISCO CA
94110-4117
US

V. Phone/Fax

Practice location:
  • Phone: 415-439-0160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number101876
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: