Provider Demographics
NPI:1477876712
Name:DESMOND, KATHRYN ELIZABETH (LAC)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ELIZABETH
Last Name:DESMOND
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 1:1195 E ARQUES AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-3904
Mailing Address - Country:US
Mailing Address - Phone:408-773-9000
Mailing Address - Fax:408-732-2906
Practice Address - Street 1:1195 E ARQUES AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-3904
Practice Address - Country:US
Practice Address - Phone:408-773-9000
Practice Address - Fax:408-732-2906
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-01
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11830171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist