Provider Demographics
NPI:1447555826
Name:STAHMER, ELIZABETH KIANU (LAC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:KIANU
Last Name:STAHMER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
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Mailing Address - Street 1:20638 PATIO DR
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5606
Mailing Address - Country:US
Mailing Address - Phone:510-754-3901
Mailing Address - Fax:510-733-2004
Practice Address - Street 1:20638 PATIO DRIVE
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-4460
Practice Address - Country:US
Practice Address - Phone:510-754-3901
Practice Address - Fax:510-733-2004
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-17
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7407171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist