Jordan Matthew Delagrange, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

83253 Issued in CA

Practice address

2801 Camino del Rio S Ste 204-7
San Diego, CA 92108-3800

Phone

(260) 444-1159

NPI assigned

Sep 30, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sanctuary of Art and Healing

  • Clinic/Center
  • San Diego, CA
  • NPI 1215782966
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632960000000",
    "number": "1033881875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2606 RIDGEWAY DR APT 3203",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919507772",
            "telephone_number": "260-444-1159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 CAMINO DEL RIO S STE 204-7",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083800",
            "telephone_number": "260-444-1159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAGRANGE",
        "first_name": "JORDAN",
        "middle_name": "MATTHEW",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-30",
        "last_updated": "2021-09-30",
        "certification_date": "2021-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "83253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Henriquez Delacruz
• Leilani Mesa Delacruz
• Nicole Marrhay Pascua Delacruz
• Yesenia Delacruz
• Carlos Alfred Delacueva
• Edward L Delaloza, L.C.S.W.
• Danisha Delancy
• Anna Katherine Delaney
• Cody Mitchell Delaney
• Cynthia Felicia Delaney

• Massage Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.