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General NPI Number Information
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NPI Number | 1972028397
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Entity Type | Organization
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Legal Business Name | ACCESS ACUPUNCTURE AND HOLISTIC HEALTH
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 4146 W 29TH ST
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City | LOS ANGELES
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State | CA
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Zip | 90016-3602
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Country | US
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Telephone | 424-371-6670
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Fax |
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Provider Business Mailing Address
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Address Line | 16787 BEACH BLVD # 115
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92647-4848
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KATRINA MARIE HALEY
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Credential | LAC
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Telephone | 424-371-6670
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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 | AC17341
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License Number State | CA
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