Provider Demographics
NPI:1225727746
Name:LAIRD, KAREN REGINA (LAC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:REGINA
Last Name:LAIRD
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 1:890 HAMPSHIRE RD STE S
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2875
Mailing Address - Country:US
Mailing Address - Phone:805-870-5076
Mailing Address - Fax:
Practice Address - Street 1:890 HAMPSHIRE RD STE S
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2875
Practice Address - Country:US
Practice Address - Phone:805-870-5076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19658171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist