Provider Demographics
NPI:1508935503
Name:LYNCH, PATRICIA (RN,MS,LAC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RN,MS,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 63RD ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-1258
Mailing Address - Country:US
Mailing Address - Phone:510-595-0959
Mailing Address - Fax:415-552-0416
Practice Address - Street 1:1080 63RD ST
Practice Address - Street 2:
Practice Address - City:EMERYVILLE
Practice Address - State:CA
Practice Address - Zip Code:94608-1258
Practice Address - Country:US
Practice Address - Phone:510-595-0959
Practice Address - Fax:415-552-0416
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 7162171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist