Provider Demographics
NPI:1376926758
Name:MAY, JOANE ANITA (DOM, LAC)
Entity Type:Individual
Prefix:
First Name:JOANE
Middle Name:ANITA
Last Name:MAY
Suffix:
Gender:F
Credentials:DOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 14TH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-3320
Mailing Address - Country:US
Mailing Address - Phone:310-917-4478
Mailing Address - Fax:
Practice Address - Street 1:1526 14TH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-3320
Practice Address - Country:US
Practice Address - Phone:310-917-4478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-03
Last Update Date:2015-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4304171100000X
NM503171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist