Provider Demographics
NPI:1043995160
Name:TURNER, RICHARD (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:TURNER
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 1:27462 PORTOLA PKWY
Mailing Address - Street 2:201
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92610
Mailing Address - Country:US
Mailing Address - Phone:949-837-8009
Mailing Address - Fax:949-837-0751
Practice Address - Street 1:27462 PORTOLA PKWY
Practice Address - Street 2:201
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92610
Practice Address - Country:US
Practice Address - Phone:949-837-8009
Practice Address - Fax:949-837-0751
Is Sole Proprietor?:No
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51058225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist