Individual provider · Type 1 NPI

Ellicia Novella Moore, CMT

Massage Therapist · Los Angeles, CA

NPI number 1700758141 Active

Practice location

912 S Dacotah St
Los Angeles, CA 90023-1623

Call (310) 591-0326 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X99760 (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 1700758141

Ellicia Novella Moore, CMT's National Provider Identifier is 1700758141, issued on Sep 23, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Los Angeles, CA. The record was last updated on Sep 23, 2025.