Healthcare Provider Details

I. General information

NPI: 1164812970
Provider Name (Legal Business Name): CHRISTY ERIN CONTRERAS L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/01/2015
Last Update Date: 11/18/2021
Certification Date: 11/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 KELLY ST
HALF MOON BAY CA
94019-1918
US

IV. Provider business mailing address

751 KELLY ST
HALF MOON BAY CA
94019-1918
US

V. Phone/Fax

Practice location:
  • Phone: 650-726-2900
  • Fax: 650-276-3189
Mailing address:
  • Phone: 650-726-2900
  • Fax: 650-276-3189

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number16337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: