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General NPI Number Information
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NPI Number | 1639722630
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Entity Type | Individual
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Provider Name | MARTHA NEUVILLE CMT, HHP
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Gender | Female
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Dates
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Enumeration Date | 07/18/2019
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Last Update Date | 07/18/2019
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Provider Practice Location Address
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Address Line | 25431 CABOT RD STE 202A
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-5527
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Country | US
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Telephone | 949-230-7002
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Fax |
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Provider Business Mailing Address
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Address Line | 19761 HIGHRIDGE WAY
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City | TRABUCO CANYON
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State | CA
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Zip | 92679-1639
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Country | US
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Telephone | 949-230-7002
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Fax | 949-459-7335
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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 | 46256
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License Number State | CA
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