Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 27064 | CA |
NPI | 1003477225 |
---|---|
Provider Name | Irene Barfoot |
First Address | San Jose, CA 95118-3207 |
Second Address | Cupertino, CA 95014-5939 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2019 |
Last Update Date | 27/06/2019 |