Individual
VANESSA PATINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
469 MAPLE AVE, VALLEJO, CA 94591-7456
(650) 308-6680
Mailing address
469 MAPLE AVE, VALLEJO, CA 94591-7456
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
63440
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
63440
MASSAGE THERAPIST
CA
Enumeration date
06/14/2022
Last updated
06/14/2022
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