Provider Demographics
NPI:1205390770
Name:KAJIMA, LUCIA FOLTANOVA (LAC)
Entity Type:Individual
Prefix:MRS
First Name:LUCIA
Middle Name:FOLTANOVA
Last Name:KAJIMA
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 1:900 FOLSOM ST APT 741
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-2176
Mailing Address - Country:US
Mailing Address - Phone:415-987-1594
Mailing Address - Fax:
Practice Address - Street 1:900 FOLSOM ST APT 741
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-2176
Practice Address - Country:US
Practice Address - Phone:415-987-1594
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17804171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty