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General NPI Number Information
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NPI Number | 1023692225
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Entity Type | Individual
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Provider Name | KRISTIAN LOLA MCADAMS LMT
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Gender | Female
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Dates
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Enumeration Date | 05/12/2021
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Last Update Date | 05/12/2021
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Provider Practice Location Address
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Address Line | 1111 N BRAND BLVD STE 402
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City | GLENDALE
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State | CA
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Zip | 91202-3071
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Country | US
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Telephone | 626-317-7330
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Fax |
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Provider Business Mailing Address
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Address Line | 2129 LA CANADA CREST DR APT 3
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City | LA CANADA FLINTRIDGE
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State | CA
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Zip | 91011-1913
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Country | US
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Telephone | 661-313-0583
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 45652
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License Number State | CA
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