Stacey Crippen

Individual provider Active NPI Massage Therapist · Orangevale, CA

NPI 1588040182 · NPPES record last updated Aug 5, 2015

Key facts

NPI
1588040182
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
60900 (CA)
Practice address
8680 Greenback LN
Ste. 110
Orangevale, CA 95662-3969
Phone
(916) 988-3379
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
60900CAMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 60900 CA Yes

Addresses

Primary practice location

8680 Greenback LN
Ste. 110
Orangevale, CA 95662-3969

Mailing address

8680 Greenback LN
Ste. 110
Orangevale, CA 95662-3969
Phone (916) 988-3379

Other providers in Orangevale, CA

All providers in Orangevale, CA · Massage Therapist in California

Sources for this page

Verify at the official NPI Registry.