Healthcare Provider Details

I. General information

NPI: 1851456255
Provider Name (Legal Business Name): LEE-YEN CHEN LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

953 W 7TH ST
OXNARD CA
93030-6756
US

IV. Provider business mailing address

953 W 7TH ST
OXNARD CA
93030-6756
US

V. Phone/Fax

Practice location:
  • Phone: 805-483-6129
  • Fax: 805-487-5576
Mailing address:
  • Phone: 805-483-6129
  • Fax: 805-487-5576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC1210
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: