Provider Demographics
NPI:1720836935
Name:PULIDO-TORRES, SAUL (MASSAGE THERAPIST)
Entity type:Individual
Prefix:MR
First Name:SAUL
Middle Name:
Last Name:PULIDO-TORRES
Suffix:
Gender:M
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 1:1542 SURREY DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95401-6033
Mailing Address - Country:US
Mailing Address - Phone:707-703-6781
Mailing Address - Fax:
Practice Address - Street 1:1542 SURREY DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95401-6033
Practice Address - Country:US
Practice Address - Phone:707-703-6781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA81287225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist