Organization
DOWNLOAD WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SURMICHE VAUGHN (CMT)
(510) 688-2919
Entity
Organization
Contact information
Practice address
1211 EMBARCADERO STE D, OAKLAND, CA 94606-5117
(510) 328-4098
Mailing address
1211 EMBARCADERO STE D, OAKLAND, CA 94606-5117
(510) 328-4098
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
05/27/2022
Last updated
05/27/2022
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