Provider Demographics
NPI:1073994992
Name:CASSLER, CARLA (LAC, DAOM)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:
Last Name:CASSLER
Suffix:
Gender:F
Credentials:LAC, DAOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 EVELYN AVE STE 221
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:CA
Mailing Address - Zip Code:94706-1375
Mailing Address - Country:US
Mailing Address - Phone:510-526-3636
Mailing Address - Fax:
Practice Address - Street 1:400 EVELYN AVE STE 221
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:CA
Practice Address - Zip Code:94706-1375
Practice Address - Country:US
Practice Address - Phone:510-526-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2456171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist