Provider Demographics
NPI:1972359701
Name:MAYFIELD, KARA LYN (CMT)
Entity Type:Individual
Prefix:
First Name:KARA
Middle Name:LYN
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:KARA
Other - Middle Name:LYN
Other - Last Name:COSSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1113 B ST
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-3012
Mailing Address - Country:US
Mailing Address - Phone:559-643-7389
Mailing Address - Fax:
Practice Address - Street 1:1113 B ST
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-3012
Practice Address - Country:US
Practice Address - Phone:559-643-7389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA78424225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist