Provider Demographics
NPI:1275279515
Name:JAMISON, JOSHLYN (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:
First Name:JOSHLYN
Middle Name:
Last Name:JAMISON
Suffix:
Gender:F
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 1:717 K ST STE 423
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-3408
Mailing Address - Country:US
Mailing Address - Phone:916-701-9866
Mailing Address - Fax:
Practice Address - Street 1:717 K ST STE 423
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-3408
Practice Address - Country:US
Practice Address - Phone:916-701-9866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-10
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90004225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA001Medicaid
CA002OtherOTHER HEALTH INSURANCE