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General NPI Number Information
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NPI Number | 1144027442
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Entity Type | Individual
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Provider Name | ANGELA RAE ALFORD CERTIFICATE
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Gender | Female
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 4640 SPYRES WAY
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City | MODESTO
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State | CA
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Zip | 95356-9800
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Country | US
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Telephone | 559-632-4716
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Fax |
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Provider Business Mailing Address
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Address Line | 6707 CALLANDER AVE
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City | RIVERBANK
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State | CA
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Zip | 95367-2204
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Country | US
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Telephone | 559-632-4716
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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 | 88282
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License Number State | CA
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