Alexandre Apostolos Theodorakis, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

73118 Issued in CA

Practice address

2615 Camino del Rio S
San Diego, CA 92108-3713

Phone

(619) 542-0884

NPI assigned

Sep 21, 2017

Sex

Male

Sole proprietor

Yes

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": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505952000000",
    "number": "1508375569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 CAMINITO TERVISO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921221980",
            "telephone_number": "858-531-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 CAMINO DEL RIO S",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083713",
            "telephone_number": "619-542-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORAKIS",
        "first_name": "ALEXANDRE",
        "middle_name": "APOSTOLOS",
        "name_prefix": "Mr.",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-21",
        "last_updated": "2017-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "73118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Daniel Then, PHARMD
• Paul Thenard III, DC
• Juliet Theng
• Jake Garrett Theobald
• Richard Charles Theobald, D.C.
• Nina E Theodoropoulos
• Shaidine Milien Theogene
• Theokratia Psychotherapy, Robinson and Associate Licensed Marriage and Family Therapists Professiona
• Theotokos, LLC
• Theralingual Speech Pathology Inc

• Massage Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2017; 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.