Active NPI
Wongwanee Waneeson
- Massage Therapist
- Cypress, CA
National Provider Identifier
1295519650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 69689
- Practice address
- 6331 Cantiles Ave
Cypress, CA 90630-5309 - Phone
- (213) 479-0598
- NPI assigned
- Aug 24, 2023
- 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 | 69689 | CA | Primary |
Addresses
Primary practice location
6331 Cantiles Ave
Cypress, CA 90630-5309
Mailing address
9925 Venice Blvd
Los Angeles, CA 90034-5111
Phone (310) 842-9561
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 |
|---|---|---|---|
| 69689 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1692835200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692835200000",
"number": "1295519650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9925 VENICE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900345111",
"telephone_number": "310-842-9561"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6331 CANTILES AVE",
"city": "CYPRESS",
"state": "CA",
"postal_code": "906305309",
"telephone_number": "213-479-0598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WANEESON",
"first_name": "WONGWANEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-24",
"last_updated": "2023-08-24",
"certification_date": "2023-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "69689",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cypress, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.