Individual provider Active NPI

Edward Paul Correa, CMT

  • Massage Therapist
  • Stockton, CA
National Provider Identifier
1376332627
Registry record updated May 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
99203 Issued in CA
Practice address
1345 N Van Buren St
Stockton, CA 95203-1841
Phone
(415) 570-2278
NPI assigned
May 3, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2025

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 99203 CA Primary

Addresses

Primary practice location

1345 N Van Buren St
Stockton, CA 95203-1841

Mailing address

1345 N Van Buren St
Stockton, CA 95203-1841
Phone (415) 570-2278

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
99203CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1746230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746230400000",
    "number": "1376332627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 N VAN BUREN ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952031841",
            "telephone_number": "415-570-2278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1345 N VAN BUREN ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952031841",
            "telephone_number": "415-570-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORREA",
        "first_name": "EDWARD",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-03",
        "last_updated": "2025-05-03",
        "certification_date": "2025-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "99203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2025; 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.