Healthcare Provider Details

I. General information

NPI: 1174427900
Provider Name (Legal Business Name): DONNA ELIZA PERRY CMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 SUNNE LN STE 112
WALNUT CREEK CA
94597-3634
US

IV. Provider business mailing address

5513 PAMPLONA CT
CONCORD CA
94521-2446
US

V. Phone/Fax

Practice location:
  • Phone: 925-378-5371
  • Fax:
Mailing address:
  • Phone: 925-339-1688
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number8389
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: