Maya's Massage Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

16356 Issued in CA

Legal business name

MAYA'S MASSAGE INC.

Doing business as

Maya's Massage Therapy

Practice address

1955 Dogwood Dr
Santa Rosa, CA 95403-1577

Phone

(415) 342-1345

NPI assigned

May 11, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Maya Nicholls, CMT

Title

President

Phone

(415) 342-1345

Specialties & licenses 1

Addresses

Other names 1

• Maya's Massage Therapy Doing business as

Locations

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1494460800000",
    "number": "1558897538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 PETALUMA BLVD N",
            "address_2": "SUITE E",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522146",
            "telephone_number": "415-342-1345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 DOGWOOD DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031577",
            "telephone_number": "415-342-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAYA'S MASSAGE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2017-05-11",
        "status": "A",
        "authorized_official_last_name": "NICHOLLS",
        "authorized_official_first_name": "MAYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "415-342-1345",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "16356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Maya's Massage Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.