Lacey Laverne Farah, ANMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

43394 Issued in CA

Practice address

400 Summit Dr
Pinole, CA 94564-1625

Phone

(707) 703-0997

NPI assigned

Sep 28, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1601251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1902413685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SUMMIT DR",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641625",
            "telephone_number": "707-703-0997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SUMMIT DR",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945641625",
            "telephone_number": "707-703-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARAH",
        "first_name": "LACEY",
        "middle_name": "LAVERNE",
        "name_prefix": "Miss",
        "credential": "ANMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-28",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "43394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bodyfixx@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "400 Summit Dr",
            "city": "Pinole",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945641625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Beverly Estes, MD
• Evan Eulner
• Queen Fabia, LVN
• Family Institute of Pinole
• Romelda Famorcan, M.S., CCC-SLP, MHPED
• Jessamine Joy Faustino-Wong, MD
• Jenna Marie Faustino
• Glen Feigelman, LCSW
• Feriel El Ghaoui DDS Inc.
• Danna Fernandez Hernandez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.