Individual provider Active NPI

Paul Brendt Svoboda, LMT

  • Massage Therapist
  • Dana Point, CA
National Provider Identifier
1346970233
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
76690 Issued in CA
Practice address
33003 Christina Dr
Dana Point, CA 92629-1009
Phone
(310) 387-2560
NPI assigned
Jun 14, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X 76690 CA Primary

Addresses

Primary practice location

33003 Christina Dr
Dana Point, CA 92629-1009

Mailing address

33003 Christina Dr
Dana Point, CA 92629-1009
Phone (310) 387-2560

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
76690CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1655164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1346970233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33003 CHRISTINA DR",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926291009",
            "telephone_number": "310-387-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33003 CHRISTINA DR",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926291009",
            "telephone_number": "310-387-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SVOBODA",
        "first_name": "PAUL",
        "middle_name": "BRENDT",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-14",
        "last_updated": "2022-06-14",
        "certification_date": "2022-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "76690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dana Point, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.