Tanya Lisa Frederick, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

43612 Issued in CA

Practice address

25040 Stewart St
Loma Linda, CA 92350-1723

Phone

(909) 206-9191

NPI assigned

Apr 25, 2024

Last updated

Apr 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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.

• The Treatment Centre, LLC

  • Massage Therapist
  • Loma Linda, CA
  • NPI 1336995893
  NPD Authorized official

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1396591814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1073",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "92354",
            "telephone_number": "909-206-9191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25040 STEWART ST",
            "city": "LOMA LINDA",
            "state": "CA",
            "postal_code": "923501723",
            "telephone_number": "909-206-9191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "TANYA",
        "middle_name": "LISA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "43612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Frank, MD
• Samuel Fransen, D.O.
• Gary Fraser, M.D.
• Teresa Frausto, M.D.
• Monica Michiels Frederick, PSY.D.
• Annalise Dariel Freed
• Hadley Dixon Freeman, MD
• Kimberly R Freeman, PHD
• Karen Phyllis Frei, M.D.
• Mary-Catherin Freier, PHD

• Massage Therapist in Loma Linda, CA
• Providers in Loma Linda, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.