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

Mr. Johnie M. Kelly Jr., CACMT

Individual provider Massage Therapist · NPI 1043809023

Mr. Johnie M. Kelly Jr., CACMT is a Massage Therapist in Los Altos, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2021
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Practice location Address checks out

895 Sherwood Ave Ste 101
Los Altos, CA 94022-1344
Phone: (650) 810-6582
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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 1148 (CA)

Record details

NPI number1043809023
Entity typeIndividual (Type 1)
GenderMale
Credentials CACMT
Sole proprietorYes
NPI enumeratedJanuary 13, 2021
Last updated in NPPESJanuary 13, 2021
Certification dateJanuary 13, 2021

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