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General NPI Number Information
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NPI Number | 1215264973
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Entity Type | Individual
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Provider Name | MONIQUE DUPREE PARKER LAC. , MSOM
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Gender | Female
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Dates
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Enumeration Date | 11/17/2009
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Last Update Date | 11/17/2009
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Provider Practice Location Address
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Address Line | 1008 S ST SUITE B
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City | SACRAMENTO
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State | CA
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Zip | 95811-6553
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Country | US
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Telephone | 530-304-3195
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Fax |
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Provider Business Mailing Address
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Address Line | 4626 COWELL BLVD
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City | DAVIS
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State | CA
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Zip | 95618
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Country | US
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Telephone | 530-304-3195
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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 | 13292
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License Number State | CA
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