Provider Demographics
NPI:1841804523
Name:SCHMALLE, MEEKA (CMT)
Entity type:Individual
Prefix:
First Name:MEEKA
Middle Name:
Last Name:SCHMALLE
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 1:24 COOLIDGE TER
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-3437
Mailing Address - Country:US
Mailing Address - Phone:141-571-4447
Mailing Address - Fax:
Practice Address - Street 1:24 COOLIDGE TER
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-3437
Practice Address - Country:US
Practice Address - Phone:415-724-4474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76089225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist