Active NPI
Carla Reyes
- Massage Therapist
- San Diego, CA
National Provider Identifier
1780308239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 60000
- Practice address
- 2907 Shelter Island Dr Ste 219
San Diego, CA 92106-2744 - Phone
- (619) 642-0477
- NPI assigned
- Sep 28, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 60000 | CA | Primary |
Addresses
Primary practice location
2907 Shelter Island Dr Ste 219
San Diego, CA 92106-2744
Mailing address
2907 Shelter Island Dr Ste 219
San Diego, CA 92106-2744
Phone (619) 642-0477
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 |
|---|---|---|---|
| 60000 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ravive Health & Vitality LLC | Massage Therapist | Current | Accepting new patients |
Locations
2907 Shelter Island Dr
Ste 219
San Diego, CA 92106
Phone (619) 642-0477
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664323200000",
"number": "1780308239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2907 SHELTER ISLAND DR STE 219",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921062744",
"telephone_number": "619-642-0477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2907 SHELTER ISLAND DR STE 219",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921062744",
"telephone_number": "619-642-0477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYES",
"first_name": "CARLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-28",
"last_updated": "2022-09-28",
"certification_date": "2022-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CA",
"license": "60000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.