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General NPI Number Information
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NPI Number | 1780919720
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Entity Type | Individual
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Provider Name | EVA REGINA TIGAN L.AC.
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Gender | Female
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 03/30/2015
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Provider Practice Location Address
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Address Line | 1509 SEABRIGHT AVE STE B2
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City | SANTA CRUZ
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State | CA
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Zip | 95062-2555
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Country | US
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Telephone | 831-234-2608
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Fax |
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Provider Business Mailing Address
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Address Line | 132 PALO VERDE TER
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City | SANTA CRUZ
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State | CA
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Zip | 95060-3225
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Country | US
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Telephone | 831-234-2608
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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 | 13349
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License Number State | CA
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