Cassie Bourdette, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

76356 Issued in CA

Practice address

4295 Gesner St Ste 3K
San Diego, CA 92117-6646

Phone

(619) 400-7049

NPI assigned

Mar 19, 2022

Last updated

Mar 19, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Holistic Solutions, Inc.

  dba Inner Balance Center

  • Massage Therapist
  • San Diego, CA
  • NPI 1912657685
  NPD Authorized official

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

{
    "created_epoch": "1647648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647648000000",
    "number": "1376292243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4295 GESNER ST STE 3K",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176646",
            "telephone_number": "619-400-7049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4295 GESNER ST STE 3K",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176646",
            "telephone_number": "619-400-7049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURDETTE",
        "first_name": "CASSIE",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-19",
        "last_updated": "2022-03-19",
        "certification_date": "2022-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "76356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yamina Boundaoui, RN
• Mark Bounthavong, PHARM.D.
• Lauren Bounyavong
• Lauren Marie Bouras
• Jeanine Michelle Bourcier, LMFT
• Ryan Beau Bourgette, MD
• David Paul Bourgouin, D.C.
• Eliza Bourke
• Margie Bourke, M.F.T.
• Valerie Lynn Bourke, AMFT, APCC

• Massage Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 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.