Staci Bokano, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

30018 Issued in CA

Practice address

6177 River Crest Dr Ste a
Riverside, CA 92507-0728

Phone

(951) 653-4480

NPI assigned

Jun 4, 2020

Last updated

Jun 4, 2020By 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

Other identifiers 1

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.

• West Coast Spine Restoration Center, Inc

  • Physical Therapist
  • Riverside, CA
  • NPI 1992887616
  NPD

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

{
    "created_epoch": "1591228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591228800000",
    "number": "1447874441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070728",
            "telephone_number": "951-653-4480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6177 RIVER CREST DR STE A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070728",
            "telephone_number": "951-653-4480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOKANO",
        "first_name": "STACI",
        "credential": "CMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-04",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "30018",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPY",
            "identifier": "300188",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Boggio
• Christian Garth Bogh
• Aaron Bohlmann, PHARMD
• Kellie Boiston
• Claudia Bojorquez
• Farhan Hussain Bokhari
• Jessica Renee Bokhari, NP
• Syed W Bokhari, M. D.
• Affa N Bokossah, LVN
• Kimberly Bolanos-Alcocer

• Massage Therapist in Riverside, CA
• Providers in Riverside, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.

Verify at the official NPI Registry.