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General NPI Number Information
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NPI Number | 1649508151
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Entity Type | Individual
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Provider Name | RAINA TSUDA DAOM, L.AC.
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Gender | Female
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 03/13/2020
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Provider Practice Location Address
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Address Line | 505 W 1ST ST
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City | TUSTIN
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State | CA
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Zip | 92780-3004
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Country | US
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Telephone | 714-386-9363
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Fax |
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Provider Business Mailing Address
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Address Line | 28985 OAK CREEK LN APT 2310
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City | AGOURA HILLS
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State | CA
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Zip | 91301-6442
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Country | US
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Telephone | 714-392-5656
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 13122
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License Number State | CA
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