Healthcare Provider Details

I. General information

NPI: 1417886573
Provider Name (Legal Business Name): JAMES LOUIS GREGORY LAKIN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9342 NALINI CT
SANTEE CA
92071-2235
US

IV. Provider business mailing address

9342 NALINI CT
SANTEE CA
92071-2235
US

V. Phone/Fax

Practice location:
  • Phone: 858-617-9394
  • Fax:
Mailing address:
  • Phone: 858-617-9394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberHL-001253-2025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: