MEDICARE: LUZ RUBY BARRIOS 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	88749	CA

General Provider Information

NPI Number	:	1528883253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUZ RUBY BARRIOS CMT

Provider Business Mailing Address
First Line	:	2044 80TH AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94621-2302
Country	:	US
Telephone Number	:	925-421-3594
Fax Number	:

Provider Business Practice Location Address
First Line	:	2411 SANTA CLARA AVE STE 24
Second Line	:
City	:	ALAMEDA
State	:	CA
Zip	:	94501-4543
Country	:	US
Telephone Number	:	925-421-3594
Fax Number	:

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

Provider Enumeration Date	:	11/18/2024
Last Update Date	:	11/18/2024

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