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General NPI Number Information
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NPI Number | 1124533534
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Entity Type | Organization
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Legal Business Name | ANNA KRASHENNNIKOVA, L. AC. , INC
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 317 N EL CAMINO REAL STE 104
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City | ENCINITAS
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State | CA
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Zip | 92024-2812
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Country | US
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Telephone | 760-710-0234
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Fax | 760-479-0233
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Provider Business Mailing Address
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Address Line | PO BOX 230341
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City | ENCINITAS
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State | CA
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Zip | 92023-0341
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Country | US
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Telephone | 760-710-0234
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Fax | 760-479-0233
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANNA KRASHENINNIKOVA
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Credential | DAOM, L.AC.
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Telephone | 760-710-0234
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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 | 14316
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License Number State | CA
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