Soulstice Spa LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SOULSTICE SPA LLC

Practice address

2462 W 3Rd St
Santa Rosa, CA 95401-6425

Phone

(707) 843-3539

NPI assigned

Jul 16, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kayse Gehret

Title

Founder

Phone

(415) 847-1644

Specialties & licenses 2

Addresses

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tatum Browne

  • Massage Therapist
  • Santa Rosa, CA
  • NPI 1750999447

  Multi-Specialty

  NPD
• Courtney Gross

  • Massage Therapist
  • Santa Rosa, CA
  • NPI 1336757012

  Multi-Specialty

  NPD
• Nicole McGovern

  • Massage Therapist
  • Santa Rosa, CA
  • NPI 1891303897

  Multi-Specialty

  NPD
• Andrea Reyes

  • Massage Therapist
  • Santa Rosa, CA
  • NPI 1679181580

  Multi-Specialty

  NPD
• Eric Wagner

  • Massage Therapist
  • Santa Rosa, CA
  • NPI 1083222905

  Multi-Specialty

  NPD
• Allison Wargo

  • Massage Therapist
  • Santa Rosa, CA
  • NPI 1790394799

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1594857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594857600000",
    "number": "1285242271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512A JOHNSON ST",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949652123",
            "telephone_number": "415-847-1644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2462 W 3RD ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954016425",
            "telephone_number": "707-843-3539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOULSTICE SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-16",
        "last_updated": "2020-07-16",
        "certification_date": "2020-07-16",
        "status": "A",
        "authorized_official_last_name": "GEHRET",
        "authorized_official_first_name": "KAYSE",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "415-847-1644"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dagoberto V Sotelo Jr.
• Laura Edith Sotelo, O.T.R.
• Ali Yohari Soto Anguiano
• David J. Soto, M.D.
• Maria Y Soto
• Khraythong Soupholphakdy
• Kaitlin Sousa
• Michael William Sousa, ASW
• Emma Nicole Souza
• Catherine Sowerby

• Physical Therapy Clinic/Center in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Physical Therapy Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2020; 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.