=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356166672
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOLPHIN PARTNERS GROUP INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/21/2024
-----------------------------------------------------
Last Update Date | 11/21/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3605 FREEPORT BLVD SUITE E
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-288-7477
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 804 CYPRESS RUN
-----------------------------------------------------
City | WOODBRIDGE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95258
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | OLYMPIA HOSTLER
-----------------------------------------------------
Credential | CMT
-----------------------------------------------------
Telephone | 917-288-7477
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------