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General NPI Number Information
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NPI Number | 1104633122
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Entity Type | Individual
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Provider Name | KIERA D LAYNE DACCHM, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 221 E WALNUT ST STE 134
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City | PASADENA
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State | CA
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Zip | 91101-1554
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Country | US
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Telephone | 626-377-9596
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Fax |
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Provider Business Mailing Address
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Address Line | 960 LARRABEE ST
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-3958
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Country | US
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Telephone | 631-478-3341
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 20241
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License Number State | CA
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