HUMBOLDT MOBILE MASSAGE, INC (NPI# 1063901767) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063901767 |
| Entity Type | Organization |
| Organization Name | HUMBOLDT MOBILE MASSAGE, INC |
| Practice Address |
1737 Margaret Ln Arcata CA 95521-6838 |
| Mailing Address |
Po Box 644 Point Arena CA 95468-0644 |
| Practice Telephone | 7078322929 |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2018-05-08 |
| Authorized Official Name | NICOLE PATTON (CEO/ MASSAGE THERAPIST) |
| Authorized Official Telephone | 7078322929 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| Street Address |
1737 MARGARET LN |
| City | ARCATA |
| State | CA |
| Zip Code | 95521-6838 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912553736 | Mcc Medical, LLC | Durable Medical Equipment & Medical Supplies | Mcc Medical, LLC, 1565 J Street, Arcata, CA 95521 | 2019-08-16 |
| 1376008599 | Nathan Klier | Behavior Technician | 901 Ost, Arcata, CA 95521 | 2019-02-01 |
| 1740753995 | Maria Sophia Stathos | Behavior Technician | 901 0 Street, Suite C, Arcata, CA 95521 | 2019-01-09 |
| 1639674146 | Choong Yuk Kim | Psychologist | 381 Bayside Rd Ste B, Arcata, CA 95521 | 2018-03-27 |
| 1194089805 | Gary Wilson Barsuaskas | Nurse Practitioner | 4677 Valley West Blvd., Arcata, CA 95521 | 2012-06-27 |
| 1265708424 | Alison Marie Palacios | Family Medicine | 3798 Janes Rd. Suite 10, Arcata, CA 95521 | 2012-03-31 |
| 1538434857 | Kristen Noell Kelley | Behavioral Analyst | 901 O Street, Suite C, Arcata, CA 95521 | 2012-03-20 |
| 1518241264 | Brian D. Lieberman | Psychologist | 730 Bayside Rd, Apt A, Arcata, CA 95521 | 2011-09-29 |
| 1427369412 | John S Yamas | Acupuncturist | 1460 G. Street, Arcata, CA 95521 | 2010-06-24 |
| 1669619391 | Kevin John Mcalerney | Massage Therapist | 770 11th Street, Lost Coast Healing Arts, Arcata, CA 95521 | 2009-01-16 |
| Find all providers in zip 95521 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
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| 1871191932 | One Family Health Enterprise | PACE Provider Organization | 206 E 185th St, Carson, CA 90746-1706 | 2020-10-12 |
| 1003445073 | North East Medical Services | PACE Provider Organization | 728 Pacific Ave Ste 201, San Francisco, CA 94133-4449 | 2020-04-02 |
| 1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
| 1669037362 | Medrev | PACE Provider Organization | 558 Chelsea Way, Corona, CA 92879-5880 | 2019-05-08 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1063988384 | Sequoia Pace, LLC. | PACE Provider Organization | 1649 Van Ness Ave, Fresno, CA 93721-1128 | 2018-10-15 |
| 1457838955 | La Coast Pace, LLC | PACE Provider Organization | 1220 E 4th St, Long Beach, CA 90802-1831 | 2018-07-26 |
| 1194202697 | Pacific Pace, LLC | PACE Provider Organization | 50 Alessandro Pl Ste A20, Pasadena, CA 91105-3149 | 2018-07-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1669986410 | Vast Oceanside Elderly Care | PACE Provider Organization | 452 Foussat Rd, Oceanside, CA 92054-4709 | 2017-11-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.