Provider Demographics
NPI:1003114463
Name:LECOMPTE, DENISE GABRIELLE (LAC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:GABRIELLE
Last Name:LECOMPTE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:495 ELWOOD AVE
Mailing Address - Street 2:SUITE #1
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-1947
Mailing Address - Country:US
Mailing Address - Phone:510-207-8261
Mailing Address - Fax:510-336-6621
Practice Address - Street 1:495 ELWOOD AVE
Practice Address - Street 2:SUITE #1
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94610-1947
Practice Address - Country:US
Practice Address - Phone:510-207-8261
Practice Address - Fax:510-336-6621
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-09
Last Update Date:2011-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9446171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist