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General NPI Number Information
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NPI Number | 1649582396
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Entity Type | Organization
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Legal Business Name | GOLETA ACUPUNCTURE WELLNESS CLINIC
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Dates
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Enumeration Date | 07/10/2010
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Last Update Date | 07/10/2010
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Provider Practice Location Address
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Address Line | 5266 HOLLISTER AVE SUITE 215
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City | SANTA BARBARA
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State | CA
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Zip | 93111-2037
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Country | US
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Telephone | 805-895-5507
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Fax | 895-967-7400
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Provider Business Mailing Address
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Address Line | 5266 HOLLISTER AVE SUITE 215
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City | SANTA BARBARA
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State | CA
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Zip | 93111
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Country | US
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Telephone | 805-895-5507
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Fax | 895-967-7400
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DAIJING LIU WANG
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Credential | L. AC.
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Telephone | 805-895-5507
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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 | AC12399
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License Number State | CA
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