Provider Demographics
NPI:1336468669
Name:HARRIS, JAMES (LAC, DIPLOM)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HARRIS
Suffix:
Gender:M
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-2935
Mailing Address - Country:US
Mailing Address - Phone:323-523-4082
Mailing Address - Fax:
Practice Address - Street 1:2200 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-2935
Practice Address - Country:US
Practice Address - Phone:323-523-4082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12982171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist