Manuel Jesus Casillas, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

76036 Issued in CA

Practice address

21330 Moneta Ave
Carson, CA 90745-1952

Phone

(310) 500-5083

NPI assigned

Mar 24, 2025

Last updated

Mar 24, 2025By the provider in NPPES

Sex

Male

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

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

{
    "created_epoch": "1742774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1457153348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21330 MONETA AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907451952",
            "telephone_number": "310-500-5083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21330 MONETA AVE",
            "city": "CARSON",
            "state": "CA",
            "postal_code": "907451952",
            "telephone_number": "310-500-5083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASILLAS",
        "first_name": "MANUEL",
        "middle_name": "JESUS",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-03-24",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "76036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carson Foot Clinic a Podiatrist Group Inc
• Carson Healthcare Services LLC
• Carson Wellness Pharmacy Inc
• Carson-Avalon Dialysis, LLC (U.S. Renal Care Carson Dialysis)
• Nyiema Desiree' Carter, PSYD
• Clyde Cassel, R. PH.
• Joletta Denise Cassel, PHARM TECH
• Myrna Lapid Cauguiran, RN
• Cebu Home Health, Inc.
• Margarette Cecilio-Roldan, FNP-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.