Healthcare Provider Details

I. General information

NPI: 1245058106
Provider Name (Legal Business Name): CALLINAN ACUPUNCTURE AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6040 COMMERCE BLVD STE 103
ROHNERT PARK CA
94928-2181
US

IV. Provider business mailing address

6040 COMMERCE BLVD STE 103
ROHNERT PARK CA
94928-2181
US

V. Phone/Fax

Practice location:
  • Phone: 707-852-4182
  • Fax: 707-852-4183
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY CALLINAN JR.
Title or Position: OWNER
Credential:
Phone: 707-852-4182