MEDICARE: LUCINDA ROSE KOTTER 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	9872	CA

General Provider Information

NPI Number	:	1487981148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUCINDA ROSE KOTTER L.AC

Provider Business Mailing Address
First Line	:	PO BOX 1690
Second Line	:
City	:	HEALDSBURG
State	:	CA
Zip	:	95448-1690
Country	:	US
Telephone Number	:	707-239-1687
Fax Number	:

Provider Business Practice Location Address
First Line	:	451 MARCH AVE STE A
Second Line	:
City	:	HEALDSBURG
State	:	CA
Zip	:	95448-3387
Country	:	US
Telephone Number	:	707-239-1687
Fax Number	:

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

Provider Enumeration Date	:	11/17/2009
Last Update Date	:	04/26/2025

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