Provider Demographics
NPI:1295183309
Name:LOU, FRISELDELYN (LAC)
Entity Type:Individual
Prefix:MRS
First Name:FRISELDELYN
Middle Name:
Last Name:LOU
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 1:582 MARKET ST STE 314
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94104-5304
Mailing Address - Country:US
Mailing Address - Phone:510-388-6077
Mailing Address - Fax:
Practice Address - Street 1:582 MARKET ST STE 314
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94104-5304
Practice Address - Country:US
Practice Address - Phone:510-388-6077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-31
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15651171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist