Active NPI
Diane Trevoledes Davis, CMT
- Massage Therapist
- Eureka, CA
National Provider Identifier
1154867299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 68808
- Practice address
- 2910 Harris St
Eureka, CA 95503-4811 - Phone
- (707) 972-0522
- NPI assigned
- Jan 12, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 68808 | CA | Primary |
Addresses
Primary practice location
2910 Harris St
Eureka, CA 95503-4811
Mailing address
2237 E St
Eureka, CA 95501-3734
Phone (707) 268-8926
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
| License | State | Type | Specialty |
|---|---|---|---|
| 68808 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1484179200000",
"number": "1154867299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2237 E ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955013734",
"telephone_number": "707-268-8926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2910 HARRIS ST",
"city": "EUREKA",
"state": "CA",
"postal_code": "955034811",
"telephone_number": "707-972-0522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "DIANE",
"middle_name": "TREVOLEDES",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-01-12",
"last_updated": "2017-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "68808",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.