Provider Demographics
NPI:1093900789
Name:YAHNER, ROXANNE AMELIA (LAC)
Entity Type:Individual
Prefix:MS
First Name:ROXANNE
Middle Name:AMELIA
Last Name:YAHNER
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 1:3447 FAY AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90232-7435
Mailing Address - Country:US
Mailing Address - Phone:310-558-1694
Mailing Address - Fax:
Practice Address - Street 1:3447 FAY AVE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90232-7435
Practice Address - Country:US
Practice Address - Phone:310-558-1694
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9450171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist