Provider Demographics
NPI:1891849584
Name:SOMMERS, FLORYDALMA P (CLMT)
Entity Type:Individual
Prefix:MRS
First Name:FLORYDALMA
Middle Name:P
Last Name:SOMMERS
Suffix:
Gender:F
Credentials:CLMT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1804 SWEET BRIAR PL
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-1257
Mailing Address - Country:US
Mailing Address - Phone:805-493-1833
Mailing Address - Fax:805-493-4545
Practice Address - Street 1:1804 SWEET BRIAR PL
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-1257
Practice Address - Country:US
Practice Address - Phone:805-493-1833
Practice Address - Fax:805-493-4545
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAMA06132225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist