Provider Demographics
NPI:1093954596
Name:WAYMAN, ANN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:
Last Name:WAYMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5762 SPA DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2027
Mailing Address - Country:US
Mailing Address - Phone:714-642-4544
Mailing Address - Fax:
Practice Address - Street 1:16511 GOLDENWEST ST STE 111
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-4484
Practice Address - Country:US
Practice Address - Phone:714-891-3201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-07
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA265240225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA431739-00OtherNATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE & BODYWORK