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General NPI Number Information
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NPI Number | 1487026621
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Entity Type | Organization
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Legal Business Name | ANGELICA MARIA SAUCEDA
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Dates
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Enumeration Date | 10/27/2015
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Last Update Date | 10/27/2015
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Provider Practice Location Address
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Address Line | 617 G ST SUITE A1
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City | DAVIS
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State | CA
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Zip | 95616-3702
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Country | US
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Telephone | 626-484-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 1729 DEL REY ST
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City | WOODLAND
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State | CA
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Zip | 95695-5401
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Country | US
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Telephone | 626-484-1133
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANGELICA SAUCEDA
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Credential |
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Telephone | 626-484-1133
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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 | 20816
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 67397
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License Number State | CA
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