KATHLYN TAN JACKSON MT NPI 1205421526

NPI Information

NPI: 1205421526
Provider Name: KATHLYN TAN JACKSON, MT
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
11770 WARNER AVE STE 123
FOUNTAIN VALLEY, CA
ZIP 92708
Phone: (714) 277-7169
Get Directions

Kathlyn Tan Jackson, MT is a massage therapist in Fountain Valley, CA. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Kathlyn Tan Jackson, MT NPI is 1205421526. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11770 WARNER AVE STE 123
FOUNTAIN VALLEY, CA
ZIP 92708-660
Phone: (714) 277-7169

The enumeration date for this NPI number is 3/8/2021 and was last updated on 3/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225700000X	Massage Therapist		39797	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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