Provider Demographics
NPI:1235305970
Name:RUDEL, ANNA (L AC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:RUDEL
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 WESTWOOD DR
Mailing Address - Street 2:STE 5
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-5110
Mailing Address - Country:US
Mailing Address - Phone:408-887-6000
Mailing Address - Fax:
Practice Address - Street 1:1610 WESTWOOD DR
Practice Address - Street 2:STE 5
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5110
Practice Address - Country:US
Practice Address - Phone:408-887-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-02
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9233171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist