Elena Fidanova, CMT
Massage Therapist in Walnut Creek, CA. Individual provider (NPI-1).
NPI number1982239331
StatusActive
Last updated in NPPESJun 16, 2021
Details
- NPI
- 1982239331
- Entity type
- Individual (NPI-1)
- Name
- Elena Fidanova
- Credential
- CMT
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Mar 5, 2020
- Certification date
- Jun 9, 2021
- Last updated
- Jun 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | 74934 | CA | Yes |
Practice location
33 St Johns CtWalnut Creek, CA 94597-3512
Phone 650-255-1155
Mailing address
33 St Johns CtWalnut Creek, CA 94597-3512
Phone 650-255-1155
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