Provider Demographics
NPI:1114048998
Name:KOWATA, DAYNA K (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:DAYNA
Middle Name:K
Last Name:KOWATA
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25431 CABOT RD STE 207
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5527
Mailing Address - Country:US
Mailing Address - Phone:949-202-0047
Mailing Address - Fax:949-205-1673
Practice Address - Street 1:25431 CABOT RD STE 207
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5527
Practice Address - Country:US
Practice Address - Phone:949-202-0047
Practice Address - Fax:949-205-1673
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9734171100000X
CAND-91175F00000X
CANP-91175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturist