MEDICARE: LIZETTE SALAZAR DESHANE DACM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	15388	CA

General Provider Information

NPI Number	:	1558706325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIZETTE SALAZAR DESHANE DACM

Provider Business Mailing Address
First Line	:	150 VALPREDA RD
Second Line	:
City	:	SAN MARCOS
State	:	CA
Zip	:	92069-2973
Country	:	US
Telephone Number	:	760-736-6767
Fax Number	:

Provider Business Practice Location Address
First Line	:	3998 VISTA WAY STE G
Second Line	:
City	:	OCEANSIDE
State	:	CA
Zip	:	92056-4514
Country	:	US
Telephone Number	:	760-736-6767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2013
Last Update Date	:	12/09/2025

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