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General NPI Number Information
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NPI Number | 1407095029
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Entity Type | Individual
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Provider Name | SHELLY ANNETTE KRAHN L.AC
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Gender | Female
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 12/10/2012
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Provider Practice Location Address
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Address Line | 9850 GENESEE AVE SUITE 860
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City | LA JOLLA
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State | CA
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Zip | 92037-1224
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Country | US
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Telephone | 760-419-6863
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Fax |
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Provider Business Mailing Address
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Address Line | 6540 REFLECTION DR #1224
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City | SAN DIEGO
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State | CA
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Zip | 92124-5119
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Country | US
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Telephone | 760-419-6863
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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 | AC3512
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License Number State | CA
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