MISS EBONIQUE ZANALE WILSON NPI 1770181521

NPI Information

NPI: 1770181521
Provider Name: MISS EBONIQUE ZANALE WILSON
Classification: Massage Therapist - 225700000X
Entity Type: Individual
Address:
380 VISTA ROMA WAY UNIT 316
SAN JOSE, CA
ZIP 95136
Phone: (408) 603-7012
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MISS Ebonique Zanale Wilson is a massage therapist in San Jose, 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. MISS Ebonique Zanale Wilson NPI is 1770181521. 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:

380 VISTA ROMA WAY UNIT 316
SAN JOSE, CA
ZIP 95136-421
Phone: (408) 603-7012

The enumeration date for this NPI number is 10/14/2020 and was last updated on 10/14/2020.

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		12550	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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