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General NPI Number Information
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NPI Number | 1699228304
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Entity Type | Organization
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Legal Business Name | ELEMENTALITY WELLNESS
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Dates
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Enumeration Date | 07/28/2016
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Last Update Date | 07/28/2016
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Provider Practice Location Address
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Address Line | 240 OAK MEADOW DR
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City | LOS GATOS
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State | CA
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Zip | 95032-4452
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Country | US
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Telephone | 408-966-9342
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Fax |
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Provider Business Mailing Address
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Address Line | 264 EVERETT AVE
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City | CAMPBELL
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State | CA
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Zip | 95008-2972
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Country | US
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Telephone | 408-966-9342
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ERIN ELIZABETH HARTNETT
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Credential | DAOM, LAC
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Telephone | 408-966-9342
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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 | 15480
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License Number State | CA
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