Kristine Jackson, MT
Individual provider Active NPI Massage Therapist · Blue Jay, CA
NPI 1316783137 · NPPES record last updated Jul 2, 2024
Key facts
- NPI
- 1316783137
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 94145 (CA)
- Practice address
- 27169 California Highway 189,
Suite 2
Blue Jay, CA 92317 - Phone
- (909) 486-9705
- Fax
- (909) 323-0215
- NPI assigned
- Jul 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Medical Technician
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist |
225700000X | 94145 | CA | Yes |
Addresses
Primary practice location
27169 California Highway 189,
Suite 2
Blue Jay, CA 92317
Mailing address
PO Box 2392
Lake Arrowhead, CA 92352-2392
Phone (909) 486-9648
Other providers in Blue Jay, CA
- Diana Haddad
- Fady Hafez
- Hearts & Lives
- Terri Lynn Horton
- Alberto Ibarra
- Kevin Herrick M.D., Inc.
- Laura Lee Larson
- Yun Nancy Lee
- Ruth E Lester
- Hans Ignatius Lim
All providers in Blue Jay, CA · Massage Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.