Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jacquelyn Fanno, CMT

Individual provider Massage Therapist · NPI 1811646433

Jacquelyn Fanno, CMT is a Massage Therapist in Tarzana, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2022
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Practice location Address checks out

18630 Burbank Blvd Apt 209
Tarzana, CA 91356-2660
Phone: (818) 514-5728
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 25356 (CA)

Record details

NPI number1811646433
Entity typeIndividual (Type 1)
GenderFemale
Credentials CMT
Sole proprietorYes
NPI enumeratedMarch 21, 2022
Last updated in NPPESMarch 21, 2022
Certification dateMarch 21, 2022

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