Healthcare Provider Details

I. General information

NPI: 1376493684
Provider Name (Legal Business Name): MR. JOSHUA FELDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/28/2026
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2044 FILLMORE ST FL 2
SAN FRANCISCO CA
94115-2781
US

IV. Provider business mailing address

1233 54TH ST
EMERYVILLE CA
94608-2634
US

V. Phone/Fax

Practice location:
  • Phone: 415-888-8368
  • Fax:
Mailing address:
  • Phone: 415-888-8368
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number30769
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: