Provider Demographics
NPI:1194453514
Name:RANGEL, PAZ GRACIELA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:PAZ GRACIELA
Middle Name:
Last Name:RANGEL
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 HEINLEN ST
Mailing Address - Street 2:
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93245-2947
Mailing Address - Country:US
Mailing Address - Phone:559-899-5222
Mailing Address - Fax:
Practice Address - Street 1:222 HEINLEN ST
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2947
Practice Address - Country:US
Practice Address - Phone:559-899-5222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-12
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA83188225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist