Healthcare Provider Details

I. General information

NPI: 1962775171
Provider Name (Legal Business Name): MARCIA STRAEHLEY L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARCIA STONE L.AC.

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 02/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 SAN LUIS RD
BERKELEY CA
94707-2053
US

IV. Provider business mailing address

810 SAN LUIS RD
BERKELEY CA
94707-2053
US

V. Phone/Fax

Practice location:
  • Phone: 510-295-3630
  • Fax: 510-527-5080
Mailing address:
  • Phone: 510-295-3630
  • Fax: 510-527-5080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC12173
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: