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General NPI Number Information
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NPI Number | 1699478636
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Entity Type | Individual
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Provider Name | SIA VICTORIA SONGCAYAUON ABITO
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Gender | Female
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Dates
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Enumeration Date | 03/27/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 2006 SANTA FE AVE
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City | LONG BEACH
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State | CA
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Zip | 90810-4044
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Country | US
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Telephone | 310-618-4726
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Fax |
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Provider Business Mailing Address
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Address Line | 2945 E 20TH ST
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City | SIGNAL HILL
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State | CA
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Zip | 90755-5634
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Country | US
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Telephone | 310-618-4726
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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 | 89899
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License Number State | CA
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