Provider Demographics
NPI:1447784160
Name:HAYWOOD-KILLINGS, MYESHIA (CMT)
Entity Type:Individual
Prefix:
First Name:MYESHIA
Middle Name:
Last Name:HAYWOOD-KILLINGS
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:MYESHIA
Other - Middle Name:
Other - Last Name:HAYWOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CMT
Mailing Address - Street 1:4326 HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:CA
Mailing Address - Zip Code:94565-6023
Mailing Address - Country:US
Mailing Address - Phone:510-927-1912
Mailing Address - Fax:
Practice Address - Street 1:4326 HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:CA
Practice Address - Zip Code:94565-6023
Practice Address - Country:US
Practice Address - Phone:510-927-1912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-19
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225700000X
CA95887225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist