Most Relevant Information
Provider Data
| NPI Number: | 1003583618 |
| Provider Name: | DEANZA DOMINGUEZ MASSAGE THERAPIST |
| Entity Type: | Individual |
| Taxonomy Code: | 225700000X |
| Specialty: | Massage Therapist |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/23/2021 |
| Last Updated: | 08/23/2021 |
Provider Practice Location
6221 WILSHIRE BLVD STE 518
LOS ANGELES
CA
900485223
Practice Location Phone/Fax
| Phone: | 3235490700 |
| Fax: |
Provider Mailing Location
6355 DE SOTO AVE APT A305
WOODLAND HILLS
CA
913672647
Provider Mailing Phone/Fax
| Phone: | 3106218529 |
| Fax: |