Azlynn Elizabeth Berry, MT

Individual provider Active NPI Massage Therapist · Calabases, CA

NPI 1124392279 · NPPES record last updated Mar 6, 2012

Key facts

NPI
1124392279
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
8244 (CA)
Practice address
4937 Las Virgenes Rd
Suite 104
Calabases, CA 91302-3559
Phone
(818) 336-1579
Fax
(818) 880-6689
NPI assigned
Mar 6, 2012
Sex
Female
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
Credentials
Medical Technician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 8244 CA Yes

Addresses

Primary practice location

4937 Las Virgenes Rd
Suite 104
Calabases, CA 91302-3559

Mailing address

5738 Whitsett Ave
Suite Number 206
Valley Village, CA 91607-1575
Phone (818) 336-1579

Sources for this page

Verify at the official NPI Registry.