Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 2878 | CA |
NPI | 1013504877 |
---|---|
Provider Name | Jolie Caldwell Ker |
First Address | Simi Valley, CA 93065-2918 |
Second Address | Simi Valley, CA 93065-2918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/12/2020 |
Last Update Date | 28/12/2020 |