=====================================================
General NPI Number Information
=====================================================
NPI Number | 1568002327
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DRESDEN HOLDEN L.AC., MACOM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2020
-----------------------------------------------------
Last Update Date | 01/09/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1805 E CABRILLO BLVD STE E
-----------------------------------------------------
City | SANTA BARBARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93108-2884
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-966-4706
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5693 W CAMINO CIELO
-----------------------------------------------------
City | SANTA BARBARA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93105-9706
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 530-966-4706
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 18708
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------