Shanna Marie Ball, C.M.T.

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

71862 Issued in CA

Practice address

4110 Sorrento Valley Blvd
San Diego, CA 92121-1429

Phone

(858) 246-9730

Fax

(858) 246-9710

NPI assigned

Jan 24, 2018

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

• Lifestyle: Wellness Professional name

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": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104324250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12548 OAK KNOLL RD APT C21",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920645494",
            "telephone_number": "928-216-0473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 SORRENTO VALLEY BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211429",
            "telephone_number": "858-246-9730",
            "fax_number": "858-246-9710"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13514 Pomerado Rd Ste L",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920643517",
            "country_code": "US",
            "telephone_number": "858-243-5632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12548 Oak Knoll Rd Apt C21",
            "address_purpose": "LOCATION",
            "city": "Poway",
            "state": "CA",
            "postal_code": "920645494",
            "country_code": "US",
            "telephone_number": "928-216-0473",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALL",
        "first_name": "SHANNA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "C.M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "71862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIFESTYLE:",
            "last_name": "WELLNESS",
            "credential": "D/B/A NAME",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Phyllis Ball
• Randiola Ball, RN,PHN,MSN
• Reyna Maybely Ball, RBT-15-05223
• Robynne Patrice Ball
• Scott Taber Ball, M.D.
• Stephen Lee Ball, DPT
• Wendy Ball
• Mustapha Khemar Ballaho, RPSGT
• Audrey Ballance
• Chesney Ballantyne

• Massage Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.