Active NPI
Julissa Amina, L.M.T.
- Massage Therapist
- San Diego, CA
National Provider Identifier
1447449624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 35126
- Practice address
- 1601 Kettner Blvd Unit 11
San Diego, CA 92101-2539 - Phone
- (808) 938-2505
- NPI assigned
- Oct 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAT 9623 | HI | |
| Massage Therapist | 225700000X | 35126 | CA | Primary |
Addresses
Primary practice location
1601 Kettner Blvd Unit 11
San Diego, CA 92101-2539
Mailing address
1948 1St Ave Apt 4
San Diego, CA 92101-2336
Phone (808) 938-2505
Other practice location 1
75-166 Kalani St Ste 203
Kailua Kona, HI 96740-1857
Phone (808) 329-5155
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 |
|---|---|---|---|
| 35126 | CA | MD | General Practice Dentistry |
| MAT 9623 | HI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598400000000",
"number": "1447449624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1948 1ST AVE APT 4",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012336",
"telephone_number": "808-938-2505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 KETTNER BLVD UNIT 11",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921012539",
"telephone_number": "808-938-2505"
}
],
"practiceLocations": [
{
"address_1": "75-166 Kalani St Ste 203",
"address_purpose": "LOCATION",
"city": "Kailua Kona",
"state": "HI",
"postal_code": "967401857",
"country_code": "US",
"telephone_number": "808-329-5155",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "AMINA",
"first_name": "JULISSA",
"name_prefix": "Miss",
"credential": "L.M.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-10-23",
"last_updated": "2020-08-26",
"certification_date": "2020-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "MAT 9623",
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "35126",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 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.