Active NPI
Nyaniso Rahotep
- Massage Therapist
- Los Angeles, CA
National Provider Identifier
1548854201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 121647
- Practice address
- 3701 W 54TH St
Los Angeles, CA 90043-2306 - Phone
- (323) 639-3191
- NPI assigned
- Feb 23, 2021
- Sex
- Male
- 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 | 121647 | CA | Primary |
Addresses
Primary practice location
3701 W 54TH St
Los Angeles, CA 90043-2306
Mailing address
3466 S Cloverdale Ave
Los Angeles, CA 90016-5214
Phone (323) 793-1159
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 |
|---|---|---|---|
| 121647 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614038400000",
"number": "1548854201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3466 S CLOVERDALE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900165214",
"telephone_number": "323-793-1159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3701 W 54TH ST",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900432306",
"telephone_number": "323-639-3191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAHOTEP",
"first_name": "NYANISO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-02-23",
"last_updated": "2021-02-23",
"certification_date": "2021-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "121647",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.