Provider Demographics
NPI:1275661050
Name:ST. JAMES, ELISABETH CAREY (LAC, MS)
Entity Type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:CAREY
Last Name:ST. JAMES
Suffix:
Gender:F
Credentials:LAC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3091 ALHAMBRA DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-7635
Mailing Address - Country:US
Mailing Address - Phone:530-672-8236
Mailing Address - Fax:530-677-1665
Practice Address - Street 1:3091 ALHAMBRA DR
Practice Address - Street 2:SUITE A
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7635
Practice Address - Country:US
Practice Address - Phone:530-672-8236
Practice Address - Fax:530-677-1665
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC-10656171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist