DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

KIMBERLY WALLACE

Active Sole Proprietor

KIMBERLY WALLACE is a Massage Therapist healthcare provider located in ATASCADERO, California. NPI 1609748748 is currently active in the NPPES registry. Verify at CMS.

Massage Therapist · ATASCADERO, CA

Registration Details

NPI Number
1609748748
Provider Type
Individual
Gender
Female
NPI Issued
Sep 18, 2025 (0.88119302029322 yrs)
Last Updated
Sep 18, 2025
License
21060 (CA)
Sole Proprietor
Yes

Practice Information

Address
8780 OLD SANTA ROSA RD
ATASCADERO, CA, 934225405
Browse CA providers · Browse ZIP 93422
Phone
8059523818
Primary Specialty
Massage Therapist
225700000X

Other Massage Therapist Providers in ATASCADERO, CA

Name Credential NPI
DORI DUECK LMT 1386885408
MOON LEAF DEROSIER CMT 1043663438
JACLYN JOYNER CMT 1164248035
MRS. NIKI MARIE TORRES CMP 1104705458
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.