Provider Demographics
NPI:1215653019
Name:TUCKER, NARA CHIMEG (LMT)
Entity type:Individual
Prefix:
First Name:NARA
Middle Name:CHIMEG
Last Name:TUCKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:NARAN
Other - Middle Name:CHIMEG
Other - Last Name:SANGI DULAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LICENSED MASSAGE THE
Mailing Address - Street 1:3030 LARKIN ST APT 102
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-1196
Mailing Address - Country:US
Mailing Address - Phone:415-760-7607
Mailing Address - Fax:
Practice Address - Street 1:900 NOE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-3309
Practice Address - Country:US
Practice Address - Phone:415-920-9766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-13
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1037688225700000X
1173346-12-171225700000X
CA1173346-12-171225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist