Individual provider Active NPI

Eric John Octaviano, CMT

  • Massage Therapist
  • Concord, CA
National Provider Identifier
1225736341
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
1333 Willow Pass Rd Ste 110
Concord, CA 94520-5225
Phone
(925) 676-7431
NPI assigned
Feb 17, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 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 CA Primary

Addresses

Primary practice location

1333 Willow Pass Rd Ste 110
Concord, CA 94520-5225

Mailing address

300 Westline Dr Apt A115
Alameda, CA 94501-5901
Phone (707) 319-6581

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

NPI Registry JSON

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

{
    "created_epoch": "1676592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1225736341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WESTLINE DR APT A115",
            "city": "ALAMEDA",
            "state": "CA",
            "postal_code": "945015901",
            "telephone_number": "707-319-6581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 WILLOW PASS RD STE 110",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "945205225",
            "telephone_number": "925-676-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OCTAVIANO",
        "first_name": "ERIC",
        "middle_name": "JOHN",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-17",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, CA

Sources for this page

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