Provider Demographics
NPI:1346786381
Name:PROFESSIONAL MASSAGE AND ESTHETICS
Entity Type:Organization
Organization Name:PROFESSIONAL MASSAGE AND ESTHETICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALESSANDRO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-500-1219
Mailing Address - Street 1:1301 S HALE AVE
Mailing Address - Street 2:#80
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-3053
Mailing Address - Country:US
Mailing Address - Phone:760-500-1219
Mailing Address - Fax:
Practice Address - Street 1:13359 POWAY RD
Practice Address - Street 2:#114
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4625
Practice Address - Country:US
Practice Address - Phone:858-371-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-14
Last Update Date:2017-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68778172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172M00000XOther Service ProvidersMechanotherapistGroup - Single Specialty