MR. JOHNIE M. KELLY CACMT NPI 1043809023

NPI Information

  • NPI: 1043809023
  • Provider Name: MR. JOHNIE M. KELLY, CACMT
  • Classification: Massage Therapist - 225700000X
  • Entity Type: Individual
  • Address: 895 SHERWOOD AVE STE 101
    LOS ALTOS, CA
    ZIP 94022
  • Phone: (650) 810-6582

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NPI Details

MR. Johnie M. Kelly, CACMT is a massage therapist in Los Altos, 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. MR. Johnie M. Kelly, CACMT NPI is 1043809023. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

895 SHERWOOD AVE STE 101
LOS ALTOS, CA
ZIP 94022-344
Phone: (650) 810-6582

The enumeration date for this NPI number is 1/13/2021 and was last updated on 1/13/2021.

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
1225700000XMassage Therapist1148CALIFORNIAYes

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: 3/30/2025

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