MEDICARE: ZEN WELLNESS LLC

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

General Provider Information

NPI Number	:	1972458255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ZEN WELLNESS LLC

Provider Business Mailing Address
First Line	:	5062 LANKERSHIM BLVD # 5065
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-4225
Country	:	US
Telephone Number	:	919-623-1627
Fax Number	:

Provider Business Practice Location Address
First Line	:	11230 OTSEGO ST
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-3783
Country	:	US
Telephone Number	:	919-623-1627
Fax Number	:

Authorized Official
Title or Position	:	MASSAGE THERAPIST
Name	:	KENDALL ERIC HOLLEY
Credential	:	CMT
Telephone Number	:	919-623-1627

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ZEN WELLNESS LLC ” Practice Location

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