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General NPI Number Information
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NPI Number | 1144361270
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Entity Type | Individual
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Provider Name | STEPHANIE ANN LUM L.AC.,R.C.P.
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Gender | Female
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Dates
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Enumeration Date | 02/10/2007
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 907 IRWIN ST
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3317
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Country | US
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Telephone | 415-459-2245
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Fax | 415-459-8938
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Provider Business Mailing Address
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Address Line | 28 LAWRENCE DR
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City | NOVATO
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State | CA
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Zip | 94945-3303
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Country | US
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Telephone | 415-892-3402
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Fax | 415-459-8938
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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 | CJ2590
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 227800000X
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Taxonomy Name | Certified Respiratory Therapist
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License Number | 8754
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License Number State | CA
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