Provider Demographics
NPI:1831654227
Name:SOUBAIGNE SAUZAY, VERONIQUE (CMT)
Entity Type:Individual
Prefix:MRS
First Name:VERONIQUE
Middle Name:
Last Name:SOUBAIGNE SAUZAY
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 1:13462 HAMMONS AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-4914
Mailing Address - Country:US
Mailing Address - Phone:408-647-4139
Mailing Address - Fax:
Practice Address - Street 1:18805 COX AVE STE 170
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4162
Practice Address - Country:US
Practice Address - Phone:669-248-9148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-10
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76786225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist