Provider Demographics
NPI:1134723935
Name:FALCON, YOMAIRA (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:YOMAIRA
Middle Name:
Last Name:FALCON
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 1:674 PROVIDENCE AVE APT A
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-2384
Mailing Address - Country:US
Mailing Address - Phone:805-825-6137
Mailing Address - Fax:
Practice Address - Street 1:674 PROVIDENCE AVE APT A
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-2384
Practice Address - Country:US
Practice Address - Phone:805-825-6137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist