Provider Demographics
NPI:1093320160
Name:PRAPIN, THUNYAVADEE
Entity Type:Individual
Prefix:MISS
First Name:THUNYAVADEE
Middle Name:
Last Name:PRAPIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3905 INGLEWOOD BLVD APT 203
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-4593
Mailing Address - Country:US
Mailing Address - Phone:818-940-5969
Mailing Address - Fax:
Practice Address - Street 1:3905 INGLEWOOD BLVD APT 203
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-4593
Practice Address - Country:US
Practice Address - Phone:818-940-5969
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6371225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist