Freddie Mitchell Ephraim, MASSAGE THERAPIST

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

44939 Issued in CA

Practice address

415 N Oakhurst Dr Apt 308
Beverly Hills, CA 90210-4051

Phone

(310) 628-6288

Fax

(310) 276-1277

NPI assigned

Jul 19, 2024

Sex

Male

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": "1721347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1881432185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9663 SANTA MONICA BLVD # 417",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104303",
            "telephone_number": "310-628-6288",
            "fax_number": "310-276-1277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N OAKHURST DR APT 308",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902104051",
            "telephone_number": "310-628-6288",
            "fax_number": "310-276-1277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPHRAIM",
        "first_name": "FREDDIE",
        "middle_name": "MITCHELL",
        "name_prefix": "Mr.",
        "credential": "MASSAGE THERAPIST",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "44939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Massage Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.