Healthcare Provider Details

I. General information

NPI: 1275721920
Provider Name (Legal Business Name): ZOE K CAHILL LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2007
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10116 JIBBOOM ST
TRUCKEE CA
96161
US

IV. Provider business mailing address

10096 OLYMPIC BLVD
TRUCKEE CA
96161
US

V. Phone/Fax

Practice location:
  • Phone: 530-562-7391
  • Fax:
Mailing address:
  • Phone: 530-562-7391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA00024076
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number20790
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: