Wildflower, Lea

Wildflower, Lea is an sole proprietor health care provider with primary practice located at 1004 Irwin St Ste A , San Rafael CA 94901-3337. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as her primary health care specialty. Wildflower, Lea can be contacted via phone (415) 320-3819.

Contact Information

Primary practice address
1004 Irwin St Ste A San Rafael CA 94901-3337
Phone: (415) 320-3819
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 22150 California

Profile Details

NPI number 1477077782
LBN Legal business name Wildflower, Lea
Credentials CMP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 28th, 2017
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477077782 NPPES
California Other 22150 CAMTC

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