Provider Demographics
NPI:1174648786
Name:LANAHAN, ASHLEY TALBOT (LAC)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:TALBOT
Last Name:LANAHAN
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 1:727 S CEDROS AVE
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1926
Mailing Address - Country:US
Mailing Address - Phone:760-529-1188
Mailing Address - Fax:
Practice Address - Street 1:135 LIVERPOOL DR
Practice Address - Street 2:SUITE B
Practice Address - City:CARDIFF BY THE SEA
Practice Address - State:CA
Practice Address - Zip Code:92007-1843
Practice Address - Country:US
Practice Address - Phone:760-753-2157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11360171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist