Healthcare Provider Details

I. General information

NPI: 1447166475
Provider Name (Legal Business Name): ELLEVATE SPA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 COMERCIO LANE
WOODLAND HILLS CA
91364-1811
US

IV. Provider business mailing address

4474 WOODMAN AVE APT 12
SHERMAN OAKS CA
91423-5551
US

V. Phone/Fax

Practice location:
  • Phone: 818-399-9361
  • Fax:
Mailing address:
  • Phone: 818-939-9361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DEBORA MARTINI LOPES
Title or Position: OWNER
Credential:
Phone: 818-399-9361