Healthcare Provider Details

I. General information

NPI: 1114048998
Provider Name (Legal Business Name): DAYNA K KOWATA N.D., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 06/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25431 CABOT RD STE 207
LAGUNA HILLS CA
92653-5527
US

IV. Provider business mailing address

25431 CABOT RD STE 207
LAGUNA HILLS CA
92653-5527
US

V. Phone/Fax

Practice location:
  • Phone: 949-202-0047
  • Fax: 949-205-1673
Mailing address:
  • Phone: 949-202-0047
  • Fax: 949-205-1673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 9734
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-91
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberNP-91
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: