Provider Demographics
NPI:1558706325
Name:SALAZAR, LIZETTE (LAC)
Entity Type:Individual
Prefix:
First Name:LIZETTE
Middle Name:
Last Name:SALAZAR
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 1:2336 HOSP WAY
Mailing Address - Street 2:#313
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-1224
Mailing Address - Country:US
Mailing Address - Phone:619-994-3530
Mailing Address - Fax:
Practice Address - Street 1:499 N EL CAMINO REAL
Practice Address - Street 2:SUITE C202
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1366
Practice Address - Country:US
Practice Address - Phone:760-230-8151
Practice Address - Fax:760-452-7579
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15388171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist