Provider Demographics
NPI:1881281244
Name:CARLIN, TESSA (CMT)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:CARLIN
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 1:260 W ALAMAR AVE APT 11
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3752
Mailing Address - Country:US
Mailing Address - Phone:347-497-0354
Mailing Address - Fax:
Practice Address - Street 1:260 W ALAMAR AVE APT 11
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3752
Practice Address - Country:US
Practice Address - Phone:347-497-0354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA84812225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist