Healthcare Provider Details

I. General information

NPI: 1275846651
Provider Name (Legal Business Name): JAMIE LIEBER M.S., L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 09/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1527 BAKER ST
SAN FRANCISCO CA
94115-2908
US

IV. Provider business mailing address

1527 BAKER ST
SAN FRANCISCO CA
94115-2908
US

V. Phone/Fax

Practice location:
  • Phone: 415-441-8158
  • Fax:
Mailing address:
  • Phone: 415-441-8158
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC11516
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: