Provider Demographics
NPI:1437363918
Name:STOKKE, DAVID (MS, LAC)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:STOKKE
Suffix:
Gender:M
Credentials:MS, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 4TH ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2430
Mailing Address - Country:US
Mailing Address - Phone:510-665-7888
Mailing Address - Fax:510-534-1634
Practice Address - Street 1:2421 4TH ST
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2430
Practice Address - Country:US
Practice Address - Phone:510-665-7888
Practice Address - Fax:510-534-1634
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11001171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist