Provider Demographics
NPI:1114236403
Name:BARTLETT, EMILY MONTES (LAC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:MONTES
Last Name:BARTLETT
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 1:19820 MONTAU DR
Mailing Address - Street 2:
Mailing Address - City:TOPANGA
Mailing Address - State:CA
Mailing Address - Zip Code:90290-3324
Mailing Address - Country:US
Mailing Address - Phone:310-968-0675
Mailing Address - Fax:
Practice Address - Street 1:12114 VENICE BLVD.
Practice Address - Street 2:OASIS HEALING CENTER
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066
Practice Address - Country:US
Practice Address - Phone:310-943-9044
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC10075171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist