Provider Demographics
NPI:1124592712
Name:MASUDA, STANLEY H (RRT-SDS, RCP, CPFT)
Entity Type:Individual
Prefix:MR
First Name:STANLEY
Middle Name:H
Last Name:MASUDA
Suffix:
Gender:M
Credentials:RRT-SDS, RCP, CPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 ROSEWOOD LN
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-2406
Mailing Address - Country:US
Mailing Address - Phone:707-290-2555
Mailing Address - Fax:
Practice Address - Street 1:901 NEVIN AVE RM 207
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:CA
Practice Address - Zip Code:94801-3143
Practice Address - Country:US
Practice Address - Phone:510-307-3055
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA909227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered