Provider Demographics
NPI:1376282434
Name:AL-NAFIS, JANON (CAMT)
Entity Type:Individual
Prefix:
First Name:JANON
Middle Name:
Last Name:AL-NAFIS
Suffix:
Gender:F
Credentials:CAMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6042 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-4011
Mailing Address - Country:US
Mailing Address - Phone:323-801-9752
Mailing Address - Fax:
Practice Address - Street 1:8725 LA TIJERA BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3906
Practice Address - Country:US
Practice Address - Phone:424-331-5661
Practice Address - Fax:213-559-8331
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-27
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60027225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA30-1025119OtherTAX ID STATE OF CLAIFORNIA