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General NPI Number Information
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NPI Number | 1942772090
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Entity Type | Individual
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Provider Name | WHITNEY JACQUELINE BIRD L.AC, DACM
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Gender | Female
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Dates
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Enumeration Date | 12/28/2018
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 147 LOMITA DR STE C
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City | MILL VALLEY
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State | CA
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Zip | 94941-1462
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Country | US
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Telephone | 415-450-5182
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Fax |
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Provider Business Mailing Address
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Address Line | 4444 REDWOOD RD
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City | NAPA
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State | CA
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Zip | 94558-9709
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Country | US
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Telephone | 415-450-5182
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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 | 18305
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License Number State | CA
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