Stephen Kimo Williams, CMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

19815 Issued in CA

Practice address

10116 Riverside Dr Ste 300
Toluca Lake, CA 91602-2544

Phone

(818) 427-9919

NPI assigned

Jul 4, 2023

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

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

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688428800000",
    "number": "1942987672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10116 RIVERSIDE DR STE 300",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10116 RIVERSIDE DR STE 300",
            "city": "TOLUCA LAKE",
            "state": "CA",
            "postal_code": "916022544",
            "telephone_number": "818-427-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "STEPHEN",
        "middle_name": "KIMO",
        "credential": "CMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-04",
        "last_updated": "2023-07-04",
        "certification_date": "2023-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "CA",
            "license": "19815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vista Center for Counseling and Psychotherapy
• Eleanor Andrea Wallen, D.P.M.
• Alex Walters, MA, BA
• Arthur William Weiss
• Marc Weiss, LMFT
• Laura Kathleen Wilson, DPT
• Robert Graham Wise Jr., MD
• Anthony Corleone Yedigaryan
• Dennis Yenn, D.P.M.
• Lawrence H. Zabner, DMD

• Massage Therapist in Toluca Lake, CA
• Providers in Toluca Lake, 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 4, 2023; 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.