Provider Demographics
NPI:1093193336
Name:HAUSER, KRISTIN (LAC)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HAUSER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2900 BRISTOL ST BLDG J
Mailing Address - Street 2:SUITE 106
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-5981
Mailing Address - Country:US
Mailing Address - Phone:714-202-7896
Mailing Address - Fax:866-706-9964
Practice Address - Street 1:2900 BRISTOL ST BLDG J
Practice Address - Street 2:SUITE 106
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-5981
Practice Address - Country:US
Practice Address - Phone:714-202-7896
Practice Address - Fax:866-706-9964
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16648171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist