Healthcare Provider Details

I. General information

NPI: 1760308837
Provider Name (Legal Business Name): LANAKILA IESU CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 LOCUST ST STE C
SANTA CRUZ CA
95060-3931
US

IV. Provider business mailing address

99 MCGIVERN WAY
SANTA CRUZ CA
95060-9320
US

V. Phone/Fax

Practice location:
  • Phone: 831-359-4753
  • Fax:
Mailing address:
  • Phone: 831-359-4753
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: