Provider Demographics
NPI:1033838917
Name:CLOUD, KRISTOPHER J (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:KRISTOPHER
Middle Name:J
Last Name:CLOUD
Suffix:
Gender:M
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2128 VAN NESS AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-2502
Mailing Address - Country:US
Mailing Address - Phone:415-531-2144
Mailing Address - Fax:
Practice Address - Street 1:447 SUTTER ST STE 421
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4618
Practice Address - Country:US
Practice Address - Phone:415-531-2144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22803225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist