Provider Demographics
NPI:1164020889
Name:ARAIZA, ADELIZ (LAC)
Entity Type:Individual
Prefix:
First Name:ADELIZ
Middle Name:
Last Name:ARAIZA
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 1:2957 22ND ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3334
Mailing Address - Country:US
Mailing Address - Phone:415-618-9824
Mailing Address - Fax:
Practice Address - Street 1:1351 HARRISON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-4334
Practice Address - Country:US
Practice Address - Phone:415-864-1070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18725171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist