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General NPI Number Information
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NPI Number | 1477137073
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Entity Type | Individual
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Provider Name | BEATRIZ DA SILVEIRA PLAKE MASSAGE THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 05/10/2021
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Last Update Date | 05/10/2021
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Provider Practice Location Address
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Address Line | 39 MILLS PL
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City | PASADENA
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State | CA
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Zip | 91105-1909
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Country | US
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Telephone | 818-486-9210
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Fax |
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Provider Business Mailing Address
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Address Line | 827 BONITA DR
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City | S PASADENA
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State | CA
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Zip | 91030-4316
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Country | US
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Telephone | 818-486-9210
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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 | 86195
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License Number State | CA
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