Stephan Utsumi

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

68768 Issued in CA

Practice address

1785 San Carlos Ave Ste 6
San Carlos, CA 94070-2026

Phone

(650) 241-4534

NPI assigned

Jul 10, 2023

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": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1619655768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1785 SAN CARLOS AVE STE 6",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1785 SAN CARLOS AVE STE 6",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702026",
            "telephone_number": "650-241-4534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UTSUMI",
        "first_name": "STEPHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "68768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• U.S. Healthworks Medical Group, PC
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• Rachel Valdez
• Olivia Valenti, FNP
• Eric Alexander Valladares
• Noelia Maribel Vallejo
• Julie Lynn Van Den Hout, C.C.P.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2023; 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.