Healthcare Provider Details

I. General information

NPI: 1356797476
Provider Name (Legal Business Name): EVGUENIA RAZINKOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2016
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 S WINCHESTER BLVD STE J210
SAN JOSE CA
95128-3904
US

IV. Provider business mailing address

1848 SARATOGA AVE 5A
SARATOGA CA
95070-6612
US

V. Phone/Fax

Practice location:
  • Phone: 408-691-7999
  • Fax:
Mailing address:
  • Phone: 408-691-7999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number52914
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: