Individual provider Active NPI

Dellon Vale, CMT, MLD-C

  • Massage Therapist
  • Santa Rosa, CA
National Provider Identifier
1376485540
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
100776 Issued in CA
Practice address
630 3Rd St
Santa Rosa, CA 95404-4403
Phone
(707) 303-7707
NPI assigned
Apr 7, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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 100776 CA Primary

Addresses

Primary practice location

630 3Rd St
Santa Rosa, CA 95404-4403

Mailing address

5929 Mark West LN
Santa Rosa, CA 95404-7509

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
100776CAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1775520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1376485540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5929 MARK WEST LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954047509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 3RD ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044403",
            "telephone_number": "707-303-7707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALE",
        "first_name": "DELLON",
        "credential": "CMT, MLD-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-07",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "100776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.