Individual
JAN HERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CLMT
Contact information
Practice address
1450 N LAKE AVE, PASADENA, CA 91104-2387
(626) 798-7805
Mailing address
9036 ARCADIA AVE APT 16, SAN GABRIEL, CA 91775-1454
(626) 616-2542
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
79049
STATE LICENSE NUMBER
CA
Enumeration date
07/10/2020
Last updated
10/21/2020
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