Provider Demographics
NPI:1457707721
Name:HILL, KAMELA ANNE (MT- MASSAGE THERAPIS)
Entity Type:Individual
Prefix:
First Name:KAMELA
Middle Name:ANNE
Last Name:HILL
Suffix:
Gender:F
Credentials:MT- MASSAGE THERAPIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 30TH ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816-3359
Mailing Address - Country:US
Mailing Address - Phone:916-469-5433
Mailing Address - Fax:916-760-8377
Practice Address - Street 1:225 30TH ST
Practice Address - Street 2:SUITE 303
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-3359
Practice Address - Country:US
Practice Address - Phone:916-469-5433
Practice Address - Fax:916-760-8377
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA37058172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA81-1234622OtherEIN