Provider Demographics
NPI:1467671404
Name:ABLONDI, LYNN CARROLL (LAC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:CARROLL
Last Name:ABLONDI
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 1:3631 MONA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95130-1334
Mailing Address - Country:US
Mailing Address - Phone:408-246-5608
Mailing Address - Fax:
Practice Address - Street 1:3031 TISCH WAY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2541
Practice Address - Country:US
Practice Address - Phone:408-260-0208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7180171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist