Healthcare Provider Details

I. General information

NPI: 1407063233
Provider Name (Legal Business Name): BARBARA JANE DAKIN OMD, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14645 MEADOW DR
GRASS VALLEY CA
95945-9070
US

IV. Provider business mailing address

14645 MEADOW DR
GRASS VALLEY CA
95945-9070
US

V. Phone/Fax

Practice location:
  • Phone: 530-272-5046
  • Fax: 530-272-5046
Mailing address:
  • Phone: 530-272-5046
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC2867
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: