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General NPI Number Information
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NPI Number | 1134068612
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Entity Type | Individual
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Provider Name | YONATAN PATINO
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Gender | Male
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 7403 RESEDA BLVD
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City | RESEDA
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State | CA
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Zip | 91335-2819
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Country | US
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Telephone | 323-616-4505
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Fax |
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Provider Business Mailing Address
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Address Line | 2649 LEDSON WAY
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City | PALMDALE
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State | CA
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Zip | 93550-6555
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Country | US
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Telephone | 323-616-4505
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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 | 40065941Z
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License Number State | CA
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