Active NPI
Lise Choukroun
- Massage Therapist
- Palm Desert, CA
National Provider Identifier
1770023285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 71308
- Practice address
- 77682 Country Club Dr Ste G
Palm Desert, CA 92211-0453 - Phone
- (760) 984-3426
- NPI assigned
- Mar 2, 2017
- 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 | 71308 | CA | Primary |
Addresses
Primary practice location
77682 Country Club Dr Ste G
Palm Desert, CA 92211-0453
Mailing address
78365 Highway 111 # 494
La Quinta, CA 92253-2071
Phone (760) 984-3426
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 |
|---|---|---|---|
| 71308 | CA | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488412800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1488412800000",
"number": "1770023285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78365 HIGHWAY 111 # 494",
"city": "LA QUINTA",
"state": "CA",
"postal_code": "922532071",
"telephone_number": "760-984-3426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77682 COUNTRY CLUB DR STE G",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "922110453",
"telephone_number": "760-984-3426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOUKROUN",
"first_name": "LISE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-03-02",
"last_updated": "2017-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "71308",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.