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

Mr. Mark Edward Vennerholm II, CMT

Individual provider Massage Therapist · NPI 1053012443

Mr. Mark Edward Vennerholm II, CMT is a Massage Therapist in Vista, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2023
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2305 S Melrose Dr Ste 103
Vista, CA 92081-8789
Phone: (760) 230-3898
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 93040 (CA)

Record details

NPI number1053012443
Entity typeIndividual (Type 1)
GenderMale
Credentials CMT
Sole proprietorYes
NPI enumeratedMarch 13, 2023
Last updated in NPPESMarch 13, 2023
Certification dateMarch 13, 2023

Other providers in Vista