Provider Demographics
NPI:1801221999
Name:LAROCHELLE, LEONA ESTHER (CMT)
Entity Type:Individual
Prefix:
First Name:LEONA
Middle Name:ESTHER
Last Name:LAROCHELLE
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 1:3627 GOLD CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-3755
Mailing Address - Country:US
Mailing Address - Phone:916-539-2795
Mailing Address - Fax:
Practice Address - Street 1:3627 GOLD CREEK LN
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-3755
Practice Address - Country:US
Practice Address - Phone:916-539-2795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-07
Last Update Date:2013-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36972225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA36972OtherCALIFORNIA MASSAGE THERAPIST COUNCIL