Provider Demographics
NPI:1588020853
Name:ZELNIK, NITZAN (LAC)
Entity Type:Individual
Prefix:
First Name:NITZAN
Middle Name:
Last Name:ZELNIK
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 1:1150 MARASCHINO DR
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94087-2101
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12280 SARATOGA SUNNYVALE RD
Practice Address - Street 2:STE. 111
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-3064
Practice Address - Country:US
Practice Address - Phone:408-242-0480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-02
Last Update Date:2016-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16465171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist