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General NPI Number Information
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NPI Number | 1447662002
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Entity Type | Individual
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Provider Name | PENNY HARRIS L.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/29/2014
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Last Update Date | 01/05/2024
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Provider Practice Location Address
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Address Line | 10116 RIVERSIDE DR STE 300
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City | TOLUCA LAKE
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State | CA
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Zip | 91602-2544
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Country | US
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Telephone | 310-498-8071
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Fax |
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Provider Business Mailing Address
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Address Line | 6200 RIVERTON AVE
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91606-3810
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Country | US
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Telephone | 310-498-8071
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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 | 15926
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License Number State | CA
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