Healthcare Provider Details
I. General information
NPI: 1558432047
Provider Name (Legal Business Name): NEKA PASQUALE L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
216 STRAWBERRY VLG # 216
MILL VALLEY CA
94941-2330
US
IV. Provider business mailing address
701 LYON ST
SAN FRANCISCO CA
94115-4365
US
V. Phone/Fax
- Phone: 415-297-9933
- Fax:
- Phone: 415-297-9933
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | AC 8353 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: