Healthcare Provider Details

I. General information

NPI: 1982116026
Provider Name (Legal Business Name): LALITA P KIRKMAN L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/30/2017
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 HARRIS CT STE A2
MONTEREY CA
93940-7823
US

IV. Provider business mailing address

1667 NOCHE BUENA ST
SEASIDE CA
93955-4419
US

V. Phone/Fax

Practice location:
  • Phone: 831-585-9608
  • Fax:
Mailing address:
  • Phone: 831-332-3656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number17588
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: