Southida Howard

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

55758 Issued in CA

Practice address

2905 Stanford Ave
Marina del Rey, CA 90292-5524

Phone

(310) 849-7799

NPI assigned

Sep 6, 2023

Last updated

Sep 6, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Southida Souratha-Howard Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Pure Bodywork

  • Massage Therapist
  • Marina del Rey, CA
  • NPI 1104697945
  NPD Authorized official

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

{
    "created_epoch": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1033995063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11072",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902957072",
            "telephone_number": "310-849-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2905 STANFORD AVE",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925524",
            "telephone_number": "310-849-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "SOUTHIDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "55758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOUTHIDA",
            "last_name": "SOURATHA-HOWARD",
            "credential": "MASSAGE THERAPIST",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Horrigan Sports Chiropractic, Inc.
• Hiroko Horstman
• Sarah Houchin, OTD, OTR/L
• Mi'Quael Alizia Houston, M.D.
• Michelle J Howard, LMFT
• Erika Michelle Hubbard, M.D.
• Laurie Hubbard, P.T.
• Joseph Hughes Jr., D.C.
• Mark Huntsinger
• Independent Surgeons of America PC

• Massage Therapist in Marina del Rey, CA
• Providers in Marina del Rey, 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 6, 2023; 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.