Healthcare Provider Details

I. General information

NPI: 1558573808
Provider Name (Legal Business Name): REBEKAH VICTORIA SITTY L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 VALENCIA ST
SAN FRANCISCO CA
94103-2318
US

IV. Provider business mailing address

220 VALENCIA ST
SAN FRANCISCO CA
94103-2318
US

V. Phone/Fax

Practice location:
  • Phone: 415-675-8973
  • Fax:
Mailing address:
  • Phone: 415-675-8973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 11120
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: