Active NPI
Joyce Donna Theobald, MASSAGE TECHNICIAN
- Massage Therapist
- Menifee, CA
National Provider Identifier
1508175811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- R-100110017
- Practice address
- 26900 Newport Rd Ste 110
Menifee, CA 92584-9224 - Phone
- (951) 672-8060
- Fax
- (951) 672-7490
- NPI assigned
- Oct 4, 2010
- Sex
- Female
- Sole proprietor
- No
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 | R-100110017 | CA | Primary |
Addresses
Primary practice location
26900 Newport Rd Ste 110
Menifee, CA 92584-9224
Mailing address
26900 Newport Rd Ste 110
Menifee, CA 92584-9224
Phone (951) 672-8060
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 |
|---|---|---|---|
| R-100110017 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286150400000",
"number": "1508175811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26900 NEWPORT RD STE 110",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925849224",
"telephone_number": "951-672-8060",
"fax_number": "951-672-7490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26900 NEWPORT RD STE 110",
"city": "MENIFEE",
"state": "CA",
"postal_code": "925849224",
"telephone_number": "951-672-8060",
"fax_number": "951-672-7490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEOBALD",
"first_name": "JOYCE",
"middle_name": "DONNA",
"name_prefix": "Mrs.",
"credential": "MASSAGE TECHNICIAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-04",
"last_updated": "2010-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "R-100110017",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Menifee, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.