Individual provider Active NPI

Wendi J Greatorex-Maldonado, MASSAGE THEAPIST

  • Massage Therapist
  • San Diego, CA
National Provider Identifier
1134823792
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
28220 Issued in CA
Practice address
9474 Kearny Villa Rd Ste 113
San Diego, CA 92126-4596
Phone
(858) 578-2070
Fax
(858) 578-2722
NPI assigned
Mar 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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 28220 CA Primary

Addresses

Primary practice location

9474 Kearny Villa Rd Ste 113
San Diego, CA 92126-4596

Mailing address

9474 Kearny Villa Rd Ste 113
San Diego, CA 92126-4596
Phone (858) 578-2070

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
28220CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1679961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1134823792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9474 KEARNY VILLA RD STE 113",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264596",
            "telephone_number": "858-578-2070",
            "fax_number": "858-578-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9474 KEARNY VILLA RD STE 113",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921264596",
            "telephone_number": "858-578-2070",
            "fax_number": "858-578-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREATOREX-MALDONADO",
        "first_name": "WENDI",
        "middle_name": "J",
        "credential": "MASSAGE THEAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-28",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "28220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; 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.