Active NPI
Irene Ammar, CMT
- Massage Therapist
- Davis, CA
National Provider Identifier
1629476262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- CMT #60412
- Practice address
- 1403 5TH St
Suite B
Davis, CA 95616-3900 - Phone
- (707) 480-1567
- NPI assigned
- Dec 14, 2014
- Sex
- Female
- 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 | CMT #60412 | CA | Primary |
Addresses
Primary practice location
1403 5TH St
Suite B
Davis, CA 95616-3900
Mailing address
1330 Antelope Ave Apt 30
Davis, CA 95616-5597
Phone (707) 480-1567
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 |
|---|---|---|---|
| CMT #60412 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418515200000",
"number": "1629476262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1330 ANTELOPE AVE APT 30",
"city": "DAVIS",
"state": "CA",
"postal_code": "956165597",
"telephone_number": "707-480-1567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1403 5TH ST",
"address_2": "SUITE B",
"city": "DAVIS",
"state": "CA",
"postal_code": "956163900",
"telephone_number": "707-480-1567"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AMMAR",
"first_name": "IRENE",
"credential": "CMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-12-14",
"last_updated": "2014-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "CMT #60412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.