Provider Demographics
NPI:1417172941
Name:CARNEY, LELA (LAC)
Entity Type:Individual
Prefix:MS
First Name:LELA
Middle Name:
Last Name:CARNEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:LELA
Other - Middle Name:C
Other - Last Name:CARNEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:143 TREE FROG LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-4856
Mailing Address - Country:US
Mailing Address - Phone:831-479-3531
Mailing Address - Fax:
Practice Address - Street 1:143 TREE FROG LN
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4856
Practice Address - Country:US
Practice Address - Phone:831-479-3531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC1463171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist