Provider Demographics
NPI:1568685667
Name:HABER, CALLY (LIC ACUPUNCTURIST)
Entity Type:Individual
Prefix:MS
First Name:CALLY
Middle Name:
Last Name:HABER
Suffix:
Gender:F
Credentials:LIC ACUPUNCTURIST
Other - Prefix:
Other - First Name:CALLY
Other - Middle Name:
Other - Last Name:HABER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LIC ACUPUNCTURIST
Mailing Address - Street 1:709 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2204
Mailing Address - Country:US
Mailing Address - Phone:831-458-0809
Mailing Address - Fax:831-458-0809
Practice Address - Street 1:709 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2204
Practice Address - Country:US
Practice Address - Phone:831-458-0809
Practice Address - Fax:831-458-0809
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3317171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist