Individual provider Active NPI

Antoinique Gray

  • Massage Therapist
  • San Leandro, CA
National Provider Identifier
1306736079
Registry record updated Jul 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
0289955556 Issued in CA
Practice address
65 Thornton St Apt 304
San Leandro, CA 94577-4845
Phone
(510) 967-0446
NPI assigned
Jul 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2025

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 0289955556 CA Primary

Addresses

Primary practice location

65 Thornton St Apt 304
San Leandro, CA 94577-4845

Mailing address

65 Thornton St Apt 304
San Leandro, CA 94577-4845
Phone (510) 967-0446

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
0289955556CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1751673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751673600000",
    "number": "1306736079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 THORNTON ST APT 304",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774845",
            "telephone_number": "510-967-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 THORNTON ST APT 304",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774845",
            "telephone_number": "510-967-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAY",
        "first_name": "ANTOINIQUE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-07-05",
        "last_updated": "2025-07-05",
        "certification_date": "2025-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "0289955556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2025; 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.