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General NPI Number Information
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NPI Number | 1316037690
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Entity Type | Organization
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Legal Business Name | CAMELLIA CITY ACUPUNCTURE, INC.
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Dates
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Enumeration Date | 10/15/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3400 COTTAGE WAY SUITE N
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City | SACRAMENTO
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State | CA
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Zip | 95825-1474
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Country | US
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Telephone | 916-486-1402
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Fax | 916-426-1382
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Provider Business Mailing Address
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Address Line | 3400 COTTAGE WAY SUITE N
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City | SACRAMENTO
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State | CA
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Zip | 95825-1474
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Country | US
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Telephone | 916-486-1402
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Fax | 916-426-1382
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. GENA LUTRICIA SPENCER
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Credential | L.AC.
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Telephone | 916-486-1402
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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 | AC5749
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License Number State | CA
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