Provider Demographics
NPI:1306502760
Name:SANIKIAN, RICHARD SARKIS (CMT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:SARKIS
Last Name:SANIKIAN
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 E EMILIE AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-4756
Mailing Address - Country:US
Mailing Address - Phone:559-273-8442
Mailing Address - Fax:
Practice Address - Street 1:2415 E EMILIE AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93730-4756
Practice Address - Country:US
Practice Address - Phone:559-273-8442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA72748225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist