Provider Demographics
NPI:1508263955
Name:HEATHER LOUNSBURY, L.AC.
Entity Type:Organization
Organization Name:HEATHER LOUNSBURY, L.AC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST/PHYSICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUNSBURY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-259-5165
Mailing Address - Street 1:1424 15TH ST APT 10
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2725
Mailing Address - Country:US
Mailing Address - Phone:310-259-5165
Mailing Address - Fax:
Practice Address - Street 1:1424 15TH ST APT 10
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2725
Practice Address - Country:US
Practice Address - Phone:310-259-5165
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC8081171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty