Provider Demographics
NPI:1225572159
Name:TAGUCHI, DEBIE AI (LAC)
Entity Type:Individual
Prefix:
First Name:DEBIE
Middle Name:AI
Last Name:TAGUCHI
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 1:9460 CUYAMACA ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SANTEE
Mailing Address - State:CA
Mailing Address - Zip Code:92071-5921
Mailing Address - Country:US
Mailing Address - Phone:619-333-8644
Mailing Address - Fax:619-312-4335
Practice Address - Street 1:9460 CUYAMACA ST STE 104
Practice Address - Street 2:
Practice Address - City:SANTEE
Practice Address - State:CA
Practice Address - Zip Code:92071-5921
Practice Address - Country:US
Practice Address - Phone:619-333-8644
Practice Address - Fax:619-312-4335
Is Sole Proprietor?:No
Enumeration Date:2016-12-12
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15671171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist