Healthcare Provider Details

I. General information

NPI: 1417224437
Provider Name (Legal Business Name): MONET ROSHAAN SEXAUER L.AC, DIPL OM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2011
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

703 MARKET ST STE 514
SAN FRANCISCO CA
94103-2134
US

IV. Provider business mailing address

703 MARKET ST STE 514
SAN FRANCISCO CA
94103-2134
US

V. Phone/Fax

Practice location:
  • Phone: 415-298-6862
  • Fax:
Mailing address:
  • Phone: 415-298-6862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number14156
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number133677
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: