Provider Demographics
NPI:1316361884
Name:TENYER, PATRICIA (LAC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:TENYER
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 1:4690 CARPINTERIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-3534
Mailing Address - Country:US
Mailing Address - Phone:805-770-0909
Mailing Address - Fax:
Practice Address - Street 1:4690 CARPINTERIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-3534
Practice Address - Country:US
Practice Address - Phone:805-770-0909
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-04
Last Update Date:2015-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15775171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist