Active NPI
Elizabeth Tis Sleeth, CMT, MA
- Massage Therapist
- Los Gatos, CA
National Provider Identifier
1457411803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 140008
- Practice address
- 16275 Los Gatos Blvd
Los Gatos, CA 95032-4519 - Phone
- (408) 402-0210
- Fax
- (408) 402-0510
- NPI assigned
- Dec 8, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 140008 | CA | Primary |
Addresses
Primary practice location
16275 Los Gatos Blvd
Los Gatos, CA 95032-4519
Mailing address
633 S 13TH St
San Jose, CA 95112-2364
Phone (408) 279-2863
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 140008 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deryke and Associates, Inc | Massage Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457411803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "633 S 13TH ST",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951122364",
"telephone_number": "408-279-2863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16275 LOS GATOS BLVD",
"city": "LOS GATOS",
"state": "CA",
"postal_code": "950324519",
"telephone_number": "408-402-0210",
"fax_number": "408-402-0510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLEETH",
"first_name": "ELIZABETH",
"middle_name": "TIS",
"credential": "CMT, MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "140008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Gatos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.