MEDICARE: JAMILA STARWELL

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	76333	CA

General Provider Information

NPI Number	:	1194304352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMILA STARWELL

Provider Business Mailing Address
First Line	:	16060 VENTURA BLVD # 454
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2761
Country	:	US
Telephone Number	:	818-376-9154
Fax Number	:

Provider Business Practice Location Address
First Line	:	8960 ORION AVE APT 19
Second Line	:
City	:	NORTH HILLS
State	:	CA
Zip	:	91343-4292
Country	:	US
Telephone Number	:	818-376-9154
Fax Number	:

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

Provider Enumeration Date	:	04/05/2021
Last Update Date	:	04/05/2021

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Directions to “ JAMILA STARWELL ” Practice Location

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