1124533534 NPI number — ANNA KRASHENNNIKOVA, L. AC. , INC

Table of content: CHRISTIE LYNN TURNER CADC,LPCC (NPI 1063450468)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124533534 NPI number — ANNA KRASHENNNIKOVA, L. AC. , INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANNA KRASHENNNIKOVA, L. AC. , INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1124533534
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/07/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 230341
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ENCINITAS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92023-0341
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
760-710-0234
Provider Business Mailing Address Fax Number:
760-479-0233

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
317 N EL CAMINO REAL STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ENCINITAS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92024-2812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
760-710-0234
Provider Business Practice Location Address Fax Number:
760-479-0233
Provider Enumeration Date:
12/07/2017

Additional Information

Authorized Official

Authorized Official Last Name:
KRASHENINNIKOVA
Authorized Official First Name:
ANNA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
760-710-0234

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  14316 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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