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NPI Code Detail

MEDICARE: MS. FRANCES NICOLAIS CMT

MEDICARE: MS. FRANCES NICOLAIS 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
1225700000XMassage Therapist14457CA

General Provider Information

NPI Number : 1194287912
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. FRANCES NICOLAIS CMT
Provider Business Mailing Address
First Line : 6911 VALMONT ST
Second Line :
City : TUJUNGA
State : CA
Zip : 91042-2013
Country : US
Telephone Number : 818-419-4001
Fax Number :
Provider Business Practice Location Address
First Line : 3460 OCEAN VIEW BLVD STE B
Second Line :
City : GLENDALE
State : CA
Zip : 91208-3306
Country : US
Telephone Number : 818-419-4001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2019
Last Update Date : 04/01/2019

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