Individual provider Active NPI

Autumn Dawn Jones

  • Massage Therapist
  • Wildomar, CA
National Provider Identifier
1356057442
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
6076 Issued in CA
Practice address
34888 Tulip LN
Wildomar, CA 92595-8814
Phone
(951) 591-0102
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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 6076 CA Primary

Addresses

Primary practice location

34888 Tulip LN
Wildomar, CA 92595-8814

Mailing address

34888 Tulip LN
Wildomar, CA 92595-8814
Phone (951) 591-0102

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

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1356057442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34888 TULIP LN",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925958814",
            "telephone_number": "951-591-0102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34888 TULIP LN",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925958814",
            "telephone_number": "951-591-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "AUTUMN",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "6076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.

Verify at the official NPI Registry.