Healthcare Provider Details

I. General information

NPI: 1396019584
Provider Name (Legal Business Name): KRISTINE PARIKIAN L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18531 ROSCOE BLVD SUITE 215
NORTHRIDGE CA
91324-4641
US

IV. Provider business mailing address

10201 ANDASOL AVE
NORTHRIDGE CA
91325-1504
US

V. Phone/Fax

Practice location:
  • Phone: 818-700-0478
  • Fax:
Mailing address:
  • Phone: 818-823-6801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number10626
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: