Provider Demographics
NPI:1558646943
Name:HERPOLSHEIMER, RHIANNON (LAC)
Entity Type:Individual
Prefix:
First Name:RHIANNON
Middle Name:
Last Name:HERPOLSHEIMER
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 1:1539 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-1639
Mailing Address - Country:US
Mailing Address - Phone:530-276-8406
Mailing Address - Fax:
Practice Address - Street 1:1539 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-1639
Practice Address - Country:US
Practice Address - Phone:530-276-8406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14393171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist