Provider Demographics
NPI:1386014306
Name:RARIG, NIKI BROOK (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:NIKI
Middle Name:BROOK
Last Name:RARIG
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 HIGUERA ST
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-2915
Mailing Address - Country:US
Mailing Address - Phone:805-543-8958
Mailing Address - Fax:805-543-4403
Practice Address - Street 1:1415 HIGUERA ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-2915
Practice Address - Country:US
Practice Address - Phone:805-543-8958
Practice Address - Fax:805-543-4403
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17662171100000X
CAND867175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist