Kathryn Debaca, A.S., LCMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

60873 Issued in CA

Practice address

1424 Morrison Ave
Stockton, CA 95205-3538

Phone

(209) 430-1461

NPI assigned

Dec 22, 2014

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Associate of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461024000000",
    "number": "1730577917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1841",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952011841",
            "telephone_number": "209-430-1461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1424 MORRISON AVE",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952053538",
            "telephone_number": "209-430-1461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEBACA",
        "first_name": "KATHRYN",
        "credential": "A.S., LCMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-22",
        "last_updated": "2016-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "60873",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "66723",
            "primary": false
        },
        {
            "code": "225500000X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist",
            "state": "CA",
            "license": "66723",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "CA",
            "license": "66723",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Degene Deshon Dean
• Shaquille Dean
• Nydea Deans
• Erica May Deaton
• Brian Allan Deaver, SUDRC
• Clifton Debaugh
• Andrea Sofia Decastro Mendez, DO
• Justin R Deckert
• Melissa Decraene, LMFT
• Dee Lords Non Emergency Transport

• Massage Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2016; 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.