Healthcare Provider Details

I. General information

NPI: 1376085340
Provider Name (Legal Business Name): LARA FOY L. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2016
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 ATLANTIC AVE STE A10
LONG BEACH CA
90807-2245
US

IV. Provider business mailing address

767 MOLINO AVE
LONG BEACH CA
90804-4759
US

V. Phone/Fax

Practice location:
  • Phone: 562-302-1272
  • Fax:
Mailing address:
  • Phone: 802-829-3005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number091.0124141
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: