Provider Demographics
NPI:1821252347
Name:BYARS, JAMES EDWARD JR (CMT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:EDWARD
Last Name:BYARS
Suffix:JR
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2939 SUMMIT ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3404
Mailing Address - Country:US
Mailing Address - Phone:510-978-8994
Mailing Address - Fax:510-452-0654
Practice Address - Street 1:2939 SUMMIT ST
Practice Address - Street 2:SUITE 301
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3404
Practice Address - Country:US
Practice Address - Phone:510-978-8994
Practice Address - Fax:510-452-0654
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA08612543225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist