LUCRETIA NAVELLE SUDDUTH-JORDAN NPI 1588274021

NPI Information

NPI: 1588274021
Provider Name: LUCRETIA NAVELLE SUDDUTH-JORDAN
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
29217 EDEN SHORES DR
HAYWARD, CA
ZIP 94545
Phone: (510) 919-3158
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Lucretia Navelle Sudduth-jordan is a massage therapist in Hayward, 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. Lucretia Navelle Sudduth-jordan NPI is 1588274021. 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:

29217 EDEN SHORES DR
HAYWARD, CA
ZIP 94545-356
Phone: (510) 919-3158

The enumeration date for this NPI number is 8/7/2020 and was last updated on 8/7/2020.

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		27561	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: 4/28/2024

NPI Synchronization or Removal

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