Individual provider Active NPI

Deedee B Gunkhasem

  • Massage Therapist
  • Redding, CA
National Provider Identifier
1063246437
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
83458 Issued in CA
Practice address
2760 Alfreda Way Apt B
Redding, CA 96002-1292
Phone
(415) 971-1677
NPI assigned
Aug 28, 2024
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 83458 CA Primary

Addresses

Primary practice location

2760 Alfreda Way Apt B
Redding, CA 96002-1292

Mailing address

2760 Alfreda Way Apt B
Redding, CA 96002-1292
Phone (415) 971-1677

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
83458CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1724803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1063246437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 ALFREDA WAY APT B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021292",
            "telephone_number": "415-971-1677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 ALFREDA WAY APT B",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960021292",
            "telephone_number": "415-971-1677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNKHASEM",
        "first_name": "DEEDEE",
        "middle_name": "B",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-28",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "83458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.