Healthcare Provider Details

I. General information

NPI: 1164815114
Provider Name (Legal Business Name): MELANI EICHENBAUM L.AC., MSTCM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 PALMETTO AVE STE D
PACIFICA CA
94044-2573
US

IV. Provider business mailing address

484 8TH AVE
SAN FRANCISCO CA
94118-3008
US

V. Phone/Fax

Practice location:
  • Phone: 650-535-0119
  • Fax:
Mailing address:
  • Phone: 831-252-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC16218
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: