Provider Demographics
NPI:1659961795
Name:AZPEITIA, LYNN (CMT, BCTMB, LE)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:AZPEITIA
Suffix:
Gender:F
Credentials:CMT, BCTMB, LE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5251 LA LUNA DR
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-2006
Mailing Address - Country:US
Mailing Address - Phone:714-309-3263
Mailing Address - Fax:
Practice Address - Street 1:5251 LA LUNA DR
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-2006
Practice Address - Country:US
Practice Address - Phone:714-309-3263
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17676225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist