Provider Demographics
NPI:1144617689
Name:LAWRENCE, SHARLEEN (LAC)
Entity Type:Individual
Prefix:
First Name:SHARLEEN
Middle Name:
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:SHARLEEN
Other - Middle Name:
Other - Last Name:FLANSAAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:225 N EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:UPLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91786-6038
Mailing Address - Country:US
Mailing Address - Phone:775-772-0158
Mailing Address - Fax:
Practice Address - Street 1:225 N EUCLID AVE
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-6038
Practice Address - Country:US
Practice Address - Phone:775-772-0158
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16581171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist