Provider Demographics
NPI:1376617589
Name:SOHONI, TERESA MARIE (LAC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIE
Last Name:SOHONI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20101 SW BIRCH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-1749
Mailing Address - Country:US
Mailing Address - Phone:949-631-2200
Mailing Address - Fax:949-631-2299
Practice Address - Street 1:425 OLD NEWPORT BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-4250
Practice Address - Country:US
Practice Address - Phone:714-337-5532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7969171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist