Individual provider Active NPI

Marisa Delia Hernandez

  • Massage Therapist
  • Oakland, CA
National Provider Identifier
1073324950
Registry record updated Jan 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
95862 Issued in CA
Practice address
420 3Rd St Ste 110
Oakland, CA 94607-3811
Phone
(510) 256-9882
NPI assigned
Jan 18, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2025

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 95862 CA Primary

Addresses

Primary practice location

420 3Rd St Ste 110
Oakland, CA 94607-3811

Mailing address

3400 Macarthur Blvd # 277
Oakland, CA 94602-3824
Phone (510) 256-9882

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
95862CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1737158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737158400000",
    "number": "1073324950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 MACARTHUR BLVD # 277",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946023824",
            "telephone_number": "510-256-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 3RD ST STE 110",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946073811",
            "telephone_number": "510-256-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNANDEZ",
        "first_name": "MARISA",
        "middle_name": "DELIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-01-18",
        "last_updated": "2025-01-18",
        "certification_date": "2025-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "95862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2025; 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.