=====================================================
General NPI Number Information
=====================================================
NPI Number | 1225584832
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN STRECKER L.AC.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2016
-----------------------------------------------------
Last Update Date | 09/01/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315A 29TH ST
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94131-2304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-225-8556
-----------------------------------------------------
Fax | 415-282-3773
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 315A 29TH STREET
-----------------------------------------------------
City | SAN FRANCISCO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94131-2304
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 415-225-8556
-----------------------------------------------------
Fax | 415-282-3773
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | AC4195
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 005703
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------