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General NPI Number Information
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NPI Number | 1548892763
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Entity Type | Individual
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Provider Name | GINA RENEE PALADY L.AC.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2020
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Last Update Date | 02/05/2020
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Provider Practice Location Address
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Address Line | 407 S MOUNT SHASTA BLVD
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City | MOUNT SHASTA
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State | CA
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Zip | 96067-2559
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Country | US
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Telephone | 530-206-3424
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Fax |
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Provider Business Mailing Address
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Address Line | 404 N MOUNT SHASTA BLVD # 350
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City | MOUNT SHASTA
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State | CA
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Zip | 96067-2232
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Country | US
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Telephone | 530-206-3424
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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 | AC7394
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License Number State | CA
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