Provider Demographics
NPI:1215016712
Name:AQUINO, CATHERINE (LAC, DIPL)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:AQUINO
Suffix:
Gender:F
Credentials:LAC, DIPL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6711 FOREST LAWN DR STE 104
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90068-1032
Mailing Address - Country:US
Mailing Address - Phone:323-642-6800
Mailing Address - Fax:
Practice Address - Street 1:6711 FOREST LAWN DR STE 104
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90068-1032
Practice Address - Country:US
Practice Address - Phone:323-851-7876
Practice Address - Fax:323-851-7870
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8332171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA0083320OtherBLUE SHIELD ID NO.