Taylor D Stein, CMT

Individual provider Active NPI Massage Therapist · Mountain Center, CA

NPI 1063173144 · NPPES record last updated Dec 31, 2021

Key facts

NPI
1063173144
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
72718 (CA)
Practice address
62025 Pinyon Dr
Mountain Center, CA 92561-3525
Phone
(760) 835-5112
NPI assigned
Dec 31, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
72718CAMDAddiction (Substance Use Disorder) Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 72718 CA Yes

Addresses

Primary practice location

62025 Pinyon Dr
Mountain Center, CA 92561-3525

Mailing address

62025 Pinyon Dr
Mountain Center, CA 92561-3525
Phone (760) 835-5112

Other identifiers

IdentifierTypeStateIssuer
461420OtherINSURANCE PLUS

Other providers in Mountain Center, CA

All providers in Mountain Center, CA · Massage Therapist in California

Sources for this page

Verify at the official NPI Registry.