MEDICARE: CASEY-LYNN TAMAYO CMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	26495	CA

General Provider Information

NPI Number	:	1043576259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASEY-LYNN TAMAYO CMT

Provider Business Mailing Address
First Line	:	2014 PALMETTO AVE
Second Line	:	SUITE D
City	:	PACIFICA
State	:	CA
Zip	:	94044-2796
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2014 PALMETTO AVE
Second Line	:	SUITE D
City	:	PACIFICA
State	:	CA
Zip	:	94044-2796
Country	:	US
Telephone Number	:	650-898-8416
Fax Number	:	650-475-1823

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2012
Last Update Date	:	04/02/2012

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Directions to “ CASEY-LYNN TAMAYO CMT” Practice Location

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