Provider Demographics
NPI:1326164542
Name:THURSTON, VALERIE ANN (CMT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:ANN
Last Name:THURSTON
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5113 PISMO CT
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8302
Mailing Address - Country:US
Mailing Address - Phone:925-550-9107
Mailing Address - Fax:
Practice Address - Street 1:1756 LACASSIE AVE
Practice Address - Street 2:102
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-7098
Practice Address - Country:US
Practice Address - Phone:925-550-9107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist