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General NPI Number Information
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NPI Number | 1194734558
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Entity Type | Individual
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Provider Name | ROSEANNA CAROL CRANE LAC
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Gender | Female
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Dates
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Enumeration Date | 08/05/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 700 E ST SUITE 100
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City | SAN RAFAEL
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State | CA
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Zip | 94901-2762
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Country | US
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Telephone | 415-256-1934
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Fax | 415-256-1934
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Provider Business Mailing Address
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Address Line | 371 FORREST AVE
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City | FAIRFAX
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State | CA
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Zip | 94930-1814
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Country | US
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Telephone | 415-460-6504
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Fax | 415-552-0416
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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 | AC5384
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License Number State | CA
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