Provider Demographics
NPI:1609042944
Name:SIENA, DUSTIN TODD (LAC, DIPLAC DAC)
Entity Type:Individual
Prefix:DR
First Name:DUSTIN
Middle Name:TODD
Last Name:SIENA
Suffix:
Gender:M
Credentials:LAC, DIPLAC DAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 E DAILY DR
Mailing Address - Street 2:SUITE # 288
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5807
Mailing Address - Country:US
Mailing Address - Phone:805-272-0019
Mailing Address - Fax:
Practice Address - Street 1:400 MOBIL AVE
Practice Address - Street 2:SUITE B-9
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6338
Practice Address - Country:US
Practice Address - Phone:805-272-0019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7304171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist