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Individual

KAREN ANN RANDOLPH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CMT, ED D

Contact information

Practice address
5 BON AIR RD STE C-116, LARKSPUR, CA 94939-1143
(510) 417-5773
Mailing address
3950 MILTON DR, EL SOBRANTE, CA 94803-3024
(510) 275-3895

Taxonomy

Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
703556
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225700000X
MASSAGE THERAPIST
CA
Enumeration date
09/04/2009
Last updated
09/04/2009
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