MR. MARK EDWARD VENNERHOLM CMT NPI 1053012443

NPI Information

NPI: 1053012443
Provider Name: MR. MARK EDWARD VENNERHOLM, CMT
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
2305 S MELROSE DR STE 103
VISTA, CA
ZIP 92081
Phone: (760) 230-3898
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MR. Mark Edward Vennerholm, CMT is a massage therapist in Vista, 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. Mark Edward Vennerholm, CMT NPI is 1053012443. 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:

2305 S MELROSE DR STE 103
VISTA, CA
ZIP 92081-789
Phone: (760) 230-3898

The enumeration date for this NPI number is 3/13/2023 and was last updated on 3/13/2023.

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		93040	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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