JESSICA BROOKE TAVISON (NPI# 1972110740) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972110740 |
| Entity Type | Individual |
| Full Name | JESSICA BROOKE TAVISON |
| Credential | LMT |
| Practice Address |
3811 Marquette Pl Apt 4x San Diego CA 92106-1073 |
| Practice Telephone | 4806960291 |
| Mailing Telephone | 4806960291 |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2020-09-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 83837 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
3811 MARQUETTE PL APT 4X |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92106-1073 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821650300 | Ktre1, LLC | Assisted Living Facility | 3219 Canon St., San Diego, CA 92106 | 2019-07-03 |
| 1093289910 | Ahsha Smith | Occupational Therapist | 2026 Roosevelt Road, #105, San Diego, CA 92106 | 2019-01-14 |
| 1710429147 | William Anthony Rodriquez | Social Worker | 140 Sylvester Ln. Building 500, Sarp Naval Base Pt Loma, San Diego, CA 92106 | 2016-11-16 |
| 1992123285 | Mark Wilson | Occupational Therapist | 2820 Roosevelt Road Ste 105, San Diego, CA 92106 | 2014-04-03 |
| 1659704542 | Sarah Hanem Izaguirre | Counselor | 2305 Historic Decatur Rd Ste 100, San Diego, CA 92106 | 2013-08-14 |
| 1285945451 | Danielle R Michaelis Castillo | Marriage & Family Therapist | 2305 Historic Decatur Rd., Suite 100, San Diego, CA 92106 | 2010-06-23 |
| 1588991145 | Philip Charles Rumsey | Dentist | 1050 Rosecrans St., Suite J, San Diego, CA 92106 | 2009-11-03 |
| 1801024575 | David Michael Spera | Dentist | 1050 Rosecrans, #j, San Diego, CA 92106 | 2009-07-01 |
| 1548408834 | Dolores Sanchez Pullen | Counselor | 1360 Rosecrans Street, Suite I, San Diego, CA 92106 | 2009-01-26 |
| 1215188362 | Jodi Lynn Ceballos | Psychologist | 2186 Historic Decatur Rd Unit 40, San Diego, CA 92106 | 2008-10-07 |
| Find all providers in zip 92106 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316548456 | Paulo Conceicao | Massage Therapist | 6559 Comly St, San Diego, CA 92111-5401 | 2020-11-05 |
| 1013517457 | Raman Khoshabeh | Massage Therapist | 12650 Sabre Springs Pkwy Ste 201, San Diego, CA 92128-4114 | 2020-10-26 |
| 1558969410 | Antonio Kinsey | Massage Therapist | 4070 Rosenda Ct Unit 217, San Diego, CA 92122-1954 | 2020-10-13 |
| 1689271298 | Ma. Luisa Garcia De Camacho | Massage Therapist | 1450 Market St Apt 449, San Diego, CA 92101-4160 | 2020-10-06 |
| 1427655034 | Svetlana Diakova | Massage Therapist | 3030 Suncrest Dr Unit 604, San Diego, CA 92116-1542 | 2020-10-06 |
| 1093312076 | Marilucia C Tolentino | Massage Therapist | 3141 Macaulay St, San Diego, CA 92106-1911 | 2020-10-02 |
| 1346856077 | Joshua Macias | Massage Therapist | 1441 9th Ave Unit 209, San Diego, CA 92101-8939 | 2020-09-18 |
| 1700492659 | Florence Yuko Casiez | Massage Therapist | 5898 Grewia St, San Diego, CA 92114-6620 | 2020-09-16 |
| 1932715968 | Tania Alvarez | Massage Therapist | 3972 Mississippi St, San Diego, CA 92104-2737 | 2020-09-15 |
| 1942814900 | Chantiana Amerson | Massage Therapist | 2464 Fenton Pkwy Apt 110, San Diego, CA 92108-6705 | 2020-09-06 |
| Find all providers in SAN DIEGO | ||||
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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.