Healthcare Provider Details

I. General information

NPI: 1508936139
Provider Name (Legal Business Name): LEAH MAZEL-GEE L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATRICIA L SHELDON L.AC.

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2046 LINCOLN ST SUITE 4
BERKELEY CA
94709-2018
US

IV. Provider business mailing address

1442A WALNUT ST BOX 430
BERKELEY CA
94709-1405
US

V. Phone/Fax

Practice location:
  • Phone: 510-548-5676
  • Fax: 510-486-1221
Mailing address:
  • Phone: 510-548-5676
  • Fax: 510-486-1221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number1497
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: