Individual provider Active NPI

Jessica Clelland, CMT

  • Massage Therapist
  • Temecula, CA
National Provider Identifier
1164992756
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
93560 Issued in CA
Practice address
40820 Winchester Rd #2505
Suite 10
Temecula, CA 92591
Phone
(956) 223-0625
NPI assigned
Nov 27, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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 93560 CA Primary

Addresses

Primary practice location

40820 Winchester Rd #2505
Suite 10
Temecula, CA 92591

Mailing address

40820 Winchester Rd #2505
Suite 10
Menifee, CA 92591
Phone (956) 223-0625

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
93560CAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lucid Speech & Language Past Accepting new patients
Lucid Speech and Language Clinic, Inc. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1164992756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40820 WINCHESTER RD #2505",
            "address_2": "SUITE 10",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "92591",
            "telephone_number": "956-223-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40820 WINCHESTER RD #2505",
            "address_2": "SUITE 10",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "92591",
            "telephone_number": "956-223-0625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLELLAND",
        "first_name": "JESSICA",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-27",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "93560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.