Debra Ann Fazio

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

55898 Issued in CA

Practice address

6653 Garner PL # a
Valley Springs, CA 95252-9425

Phone

(415) 532-6219

NPI assigned

Feb 9, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1043074032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6653 GARNER PL # A",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952529425",
            "telephone_number": "415-532-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6653 GARNER PL # A",
            "city": "VALLEY SPRINGS",
            "state": "CA",
            "postal_code": "952529425",
            "telephone_number": "415-532-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAZIO",
        "first_name": "DEBRA",
        "middle_name": "ANN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "55898",
            "primary": true
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "CA",
            "license": "7517155132",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "CA",
            "license": "01264265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Nicole Date-Chong, PNP
• Tamara Davis, LCSW
• Stephanie Ann Dilliner, PT
• James B. Duhamel, DDS
• Benedicto M Estoesta, M.D.
• Rosa Garcia-Lopez
• Gold Country Therapies, Inc
• James P Green, DDS
• Gregory a. Bloom
• Sarah Hall, CPM

• Massage Therapist in Valley Springs, CA
• Providers in Valley Springs, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.