Provider Demographics
NPI:1497143341
Name:CERAMI, NISAN SAADET (LAC)
Entity Type:Individual
Prefix:MS
First Name:NISAN
Middle Name:SAADET
Last Name:CERAMI
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 1:230 BEDFORD PL
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5325
Mailing Address - Country:US
Mailing Address - Phone:805-338-6600
Mailing Address - Fax:
Practice Address - Street 1:2277 TOWNSGATE RD
Practice Address - Street 2:SUITE 214
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2406
Practice Address - Country:US
Practice Address - Phone:805-338-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-30
Last Update Date:2014-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16214171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist