Provider Demographics
NPI:1467601575
Name:HORN, DEBRA ANN (LAC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:HORN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15247 W SUNSET BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:PACIFIC PALISADES
Mailing Address - State:CA
Mailing Address - Zip Code:90272-3624
Mailing Address - Country:US
Mailing Address - Phone:310-459-4416
Mailing Address - Fax:
Practice Address - Street 1:15247 W SUNSET BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:PACIFIC PALISADES
Practice Address - State:CA
Practice Address - Zip Code:90272-3624
Practice Address - Country:US
Practice Address - Phone:310-459-4416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8160171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist