Provider Demographics
NPI:1558814046
Name:RAPPOPORT, ABBY (LAC)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:RAPPOPORT
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 1:2108 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-4616
Mailing Address - Country:US
Mailing Address - Phone:805-628-2142
Mailing Address - Fax:
Practice Address - Street 1:1616 CHAPALA ST
Practice Address - Street 2:SUITE #2
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-5953
Practice Address - Country:US
Practice Address - Phone:805-628-2142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-01
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14715171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist