Stephanie Bracamontes Canedo
Massage Therapist in Riverside, CA. Individual provider (NPI-1).
NPI number1134812324
StatusActive
Last updated in NPPESJun 1, 2023
Details
- NPI
- 1134812324
- Entity type
- Individual (NPI-1)
- Name
- Stephanie Bracamontes Canedo
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 1, 2023
- Certification date
- Jun 1, 2023
- Last updated
- Jun 1, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 87430 | CA | Yes |
Practice location
5880 Fair Isle Dr Apt 70Riverside, CA 92507-8454
Phone 760-235-0014
Mailing address
5880 Fair Isle Dr Apt 70Riverside, CA 92507-8454
Phone 760-235-0014
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