Myesha Fuller, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

40742 Issued in CA

Practice address

8725 La Tijera Blvd
Los Angeles, CA 90045-3906

Phone

(424) 331-5661

NPI assigned

Nov 14, 2019

Last updated

Nov 14, 2019By the provider in NPPES

Sex

Female

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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1578108486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8725 LA TIJERA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453906",
            "telephone_number": "424-331-5661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8725 LA TIJERA BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900453906",
            "telephone_number": "424-331-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "MYESHA",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "40742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Fuller, MA
• Jack G. Fuller, PA-C
• Jennifer Elizabeth Fuller, PT
• Laura Marie Fuller, MFT INTERN
• M. Camille Fuller, D.D.S.
• Perry Fuller
• Samantha Elizeth Fuller
• Solomon Fuller
• Fullfill, Inc.
• Howard J. Fullman, MD

• Massage Therapist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.