Provider Demographics
NPI:1053059238
Name:MATTHYSSE, SONYA NANETTE (RWP, NC)
Entity Type:Individual
Prefix:
First Name:SONYA
Middle Name:NANETTE
Last Name:MATTHYSSE
Suffix:
Gender:F
Credentials:RWP, NC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:249 MYRTLE ST
Mailing Address - Street 2:
Mailing Address - City:HALF MOON BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94019-1825
Mailing Address - Country:US
Mailing Address - Phone:408-500-9920
Mailing Address - Fax:
Practice Address - Street 1:249 MYRTLE ST
Practice Address - Street 2:
Practice Address - City:HALF MOON BAY
Practice Address - State:CA
Practice Address - Zip Code:94019-1825
Practice Address - Country:US
Practice Address - Phone:408-500-9920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-26
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach