Tina Hope Distad, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

71677 Issued in CA

Practice address

3540 Soquel Ave Ste C2
Santa Cruz, CA 95062-1769

Phone

(831) 291-5008

NPI assigned

Feb 23, 2015

Last updated

Mar 2, 2023By 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 2

Addresses

Electronic endpoints 1

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": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677715200000",
    "number": "1700278017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 SOQUEL AVE STE C2",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621769",
            "telephone_number": "831-291-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 SOQUEL AVE STE C2",
            "city": "SANTA CRUZ",
            "state": "CA",
            "postal_code": "950621769",
            "telephone_number": "831-291-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTAD",
        "first_name": "TINA",
        "middle_name": "HOPE",
        "name_prefix": "Miss",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2023-03-02",
        "certification_date": "2023-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "60351627",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "71677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "massageforsantacruz.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3540 Soquel Ave Ste C2",
            "city": "Santa Cruz",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950621769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Dignity Health Medical Foundation (Dignity Health Medical Group - Dominican, a service of Dignity Health)
• Cindy Dillard, NP
• Courtney Jane Dimpel
• Caitlin Nicole Dios, ATC
• Casey Diraimondo, BA
• Divine Senior Care Inc.
• Jessica Wall Divine, M.D.
• Lauren Camile Dixon, CASE MANAGER
• Jasmine Dizon
• Daniel David Dlubac

• Massage Therapist in Santa Cruz, CA
• Providers in Santa Cruz, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 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.