Active NPI
William Joseph Theriault, MASSAGE PRACTITIONE
- Massage Therapist
- Fountain Valley, CA
National Provider Identifier
1366054215
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 27601
- Practice address
- 8840 Warner Ave
Suite 100
Fountain Valley, CA 92708 - Phone
- (714) 898-0515
- NPI assigned
- Aug 21, 2020
- Sex
- Male
- Sole proprietor
- No
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 | 27601 | CA | Primary |
Addresses
Primary practice location
8840 Warner Ave
Suite 100
Fountain Valley, CA 92708
Mailing address
2601 Huntington St.
#7
Huntington Beach, CA 92648
Phone (714) 260-8487
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27601 | Other | CA | MASSAGE PRACTITIONER |
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 |
|---|---|---|---|
| 27601 | CA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1366054215",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2601 HUNTINGTON ST.",
"address_2": "#7",
"city": "HUNTINGTON BEACH",
"state": "CA",
"postal_code": "92648",
"telephone_number": "714-260-8487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8840 WARNER AVE",
"address_2": "SUITE 100",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "92708",
"telephone_number": "714-898-0515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THERIAULT",
"first_name": "WILLIAM",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "MASSAGE PRACTITIONE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-21",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "27601",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSAGE PRACTITIONER",
"identifier": "27601",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fountain Valley, CA
- The Ocd Treatment Center
- The Reckless Recover
- The Road to Recovery Treatment Services (The Road)
- The Stephouse Recovery, Inc. (The StepHouse Recovery)
- Daniel James Theilen, PTA
- Thimy D. Le DMD, Inc. (Bleach)
- Surinder S Thind, M.D.,FACC
- Thomas J Asciuto MD Corporation
- Thomas T. Nguyen, M.D., Inc.
- John Michael Thomas Jr., MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.