MISS EBONIQUE ZANALE WILSON (NPI# 1770181521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770181521 |
| Entity Type | Individual |
| Full Name | MISS EBONIQUE ZANALE WILSON |
| Practice Address |
380 Vista Roma Way Unit 316 San Jose CA 95136-4421 |
| Practice Telephone | 4086037012 |
| Mailing Telephone | 4086037012 |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-10-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 12550 | CA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
380 VISTA ROMA WAY UNIT 316 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95136-4421 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245709757 | Rahwa Ferzghi | Behavior Technician | 5300 Terner Way Apt 3102, San Jose, CA 95136 | 2018-11-14 |
| 1285110254 | Brittany Lauren Perez | Behavioral Analyst | 4501 Snell Ave Apt 208, San Jose, CA 95136 | 2018-07-12 |
| 1316466139 | Melinda Fike Vertin | Nurse Practitioner | 970 Glenridge Dr., San Jose, CA 95136 | 2017-09-12 |
| 1841712221 | Cynthia Castillo | Spec/Tech, Cardiovascular | 4742 Canyon River Court, San Josse, CA 95136 | 2017-07-07 |
| 1841609732 | Elizabeth Mary Myers | Specialist/Technologist | 385 Vista Roma Way #302, San Jose, CA 95136 | 2014-08-05 |
| 1649696717 | David W Chan | Dentist | 1095 Branham Ln., Suite #101, San Jose, CA 95136 | 2014-03-12 |
| 1811323686 | Krystle Wright | Speech-Language Pathologist | 368 Maeve Court, San Jose, CA 95136 | 2013-09-24 |
| 1043598196 | Anh-thu Huynh | Optometrist | 4807 Rue Loiret, San Jose, CA 95136 | 2011-07-22 |
| 1740437029 | Center for Autism and Related Disorders LLC | Community/Behavioral Health | 3610 Snell Ave, San Jose, CA 95136 | 2008-08-19 |
| 1366655201 | Zaidoon R. Owais | Dentist | 511 W. Capitol Expwy, San Jose, CA 95136 | 2007-05-08 |
| Find all providers in zip 95136 | ||||
| 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 |
|---|---|---|---|---|
| 1225635162 | Veronica Isabel Foggie | Massage Therapist | 3570 Ct, San Jose, CA 95127 | 2020-10-05 |
| 1659988897 | Francis Beaudry | Massage Therapist | 1374 Piland Dr, San Jose, CA 95130-1339 | 2020-09-30 |
| 1972118586 | Niane Oliveira Ribeiro De Sa | Massage Therapist | 1174 Lincoln Ave Ste 5, San Jose, CA 95125-3029 | 2020-09-10 |
| 1164061412 | Castrell Neuromuscular Therapy | Massage Therapist | 3880 S Bascom Ave Ste 108, San Jose, CA 95124-2600 | 2020-01-04 |
| 1285192468 | Mae Rose Corley | Massage Therapist | 841 Blossom Hill Rd Ste 108, San Jose, CA 95123-2704 | 2019-03-07 |
| 1750870747 | Gertrud Stojancic | Massage Therapist | 3315 Almaden Expressway, # 27/29, San Jose, CA 95125 | 2018-05-04 |
| 1457889958 | Chris Shelton | Massage Therapist | 1314 Lincoln Ave Ste 2b, San Jose, CA 95125-3012 | 2017-05-27 |
| 1477098572 | Richard C Rhodes | Massage Therapist | 2618 Hill Park Dr, San Jose, CA 95124-1734 | 2016-12-27 |
| 1114398658 | Myung Sook Lee | Massage Therapist | 765 Modern Ice Dr, San Jose, CA 95112-4857 | 2015-10-09 |
| 1043616493 | Douglas Olson | Massage Therapist | 1082 Almaden Village Ln, San Jose, CA 95120-3365 | 2014-11-12 |
| Find all providers in SAN JOSE | ||||
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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.