Healthcare Provider Details

I. General information

NPI: 1508216748
Provider Name (Legal Business Name): JACQUELINE SOHN L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2016
Last Update Date: 06/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 ELLIS ST
SAN FRANCISCO CA
94115-4215
US

IV. Provider business mailing address

1355 ELLIS ST
SAN FRANCISCO CA
94115-4215
US

V. Phone/Fax

Practice location:
  • Phone: 415-596-7026
  • Fax: 415-567-5933
Mailing address:
  • Phone: 415-596-7026
  • Fax: 415-567-5933

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC9123
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: