Provider Demographics
NPI:1962126854
Name:ADES, ANNA MARIA (CMT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIA
Last Name:ADES
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 1:1665 ALHAMBRA LN
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-2229
Mailing Address - Country:US
Mailing Address - Phone:510-816-0282
Mailing Address - Fax:
Practice Address - Street 1:1665 ALHAMBRA LN
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-2229
Practice Address - Country:US
Practice Address - Phone:510-816-0282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11712225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty