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General NPI Number Information
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NPI Number | 1427344936
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Entity Type | Organization
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Legal Business Name | DAKINI ENTERPRISES
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Dates
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Enumeration Date | 06/22/2011
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Last Update Date | 06/22/2011
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Provider Practice Location Address
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Address Line | 611 COLORADO AVE
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City | SANTA MONICA
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State | CA
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Zip | 90401-2507
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Country | US
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Telephone | 310-428-4642
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Fax |
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Provider Business Mailing Address
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Address Line | 611 COLORADO AVE
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City | SANTA MONICA
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State | CA
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Zip | 90401-2507
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PAIGE HETHERINGTON
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Credential |
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Telephone | 310-428-4642
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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 | 9664
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License Number State | CA
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