Jessica Llerena, MT.0023755

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

0023755 Issued in CO

Practice address

2405 Willow Tree GRV Apt 204
Colorado Springs, CO 80910-7126

Phone

(754) 209-6094

NPI assigned

Nov 10, 2020

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": "1604966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1669074183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 WILLOW TREE GRV APT 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809107126",
            "telephone_number": "754-209-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 WILLOW TREE GRV APT 204",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809107126",
            "telephone_number": "754-209-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LLERENA",
        "first_name": "JESSICA",
        "credential": "MT.0023755",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CO",
            "license": "0023755",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Massage Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.