Healthcare Provider Details

I. General information

NPI: 1780866699
Provider Name (Legal Business Name): DAWN MARIE WAFER L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2007
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 E HIGHWAY 246 SUITE C
BUELLTON CA
93427-9653
US

IV. Provider business mailing address

254 E HIGHWAY 246 STE C
BUELLTON CA
93427-9653
US

V. Phone/Fax

Practice location:
  • Phone: 805-895-1164
  • Fax:
Mailing address:
  • Phone: 805-895-1164
  • Fax: 805-693-4677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number11733
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: