Individual provider · Type 1 NPI

Kimberly Wallace

Massage Therapist · Atascadero, CA

NPI number 1609748748 Active

Practice location

8780 Old Santa Rosa Rd
Atascadero, CA 93422-5405

Call (805) 952-3818 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X21060 (CA)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1609748748

Kimberly Wallace's National Provider Identifier is 1609748748, issued on Sep 18, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Atascadero, CA. The record was last updated on Sep 18, 2025.