Provider Demographics
NPI:1487229233
Name:NOGUCHI, NAOKO (LAC)
Entity Type:Individual
Prefix:
First Name:NAOKO
Middle Name:
Last Name:NOGUCHI
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 1:4950 BARRANCA PKWY STE 301
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4631
Mailing Address - Country:US
Mailing Address - Phone:657-229-2584
Mailing Address - Fax:
Practice Address - Street 1:4950 BARRANCA PKWY STE 301
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4631
Practice Address - Country:US
Practice Address - Phone:657-229-2584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15542171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty