MEDICARE: RACHAEL LEIGH HENRICHSEN L.AC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	AC 16718	CA

General Provider Information

NPI Number	:	1033583505
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL LEIGH HENRICHSEN L.AC

Provider Business Mailing Address
First Line	:	2912 DIAMOND ST # 334
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-3208
Country	:	US
Telephone Number	:	305-742-7261
Fax Number	:

Provider Business Practice Location Address
First Line	:	2912 DIAMOND ST # 334
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94131-3208
Country	:	US
Telephone Number	:	305-742-7261
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/21/2015
Last Update Date	:	11/21/2015

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