Healthcare Provider Details

I. General information

NPI: 1881506376
Provider Name (Legal Business Name): EMILY BERNSTEIN LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 SWANTON RD
DAVENPORT CA
95017-9711
US

IV. Provider business mailing address

PO BOX 1236
EL GRANADA CA
94018-1236
US

V. Phone/Fax

Practice location:
  • Phone: 650-318-3950
  • Fax:
Mailing address:
  • Phone: 650-483-5859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: