Provider Demographics
NPI:1104798701
Name:MALCHOW-HAY, TWYLA KAYLEE (CMT)
Entity type:Individual
Prefix:
First Name:TWYLA
Middle Name:KAYLEE
Last Name:MALCHOW-HAY
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 1:1640 ASHBY AVE APT D
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94703-2328
Mailing Address - Country:US
Mailing Address - Phone:510-689-1771
Mailing Address - Fax:
Practice Address - Street 1:1640 ASHBY AVE APT D
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94703-2328
Practice Address - Country:US
Practice Address - Phone:510-689-1771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
CA100279225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No374J00000XNursing Service Related ProvidersDoula