Provider Demographics
NPI:1639633316
Name:CASA ZEN ACUPUNCTURE INC
Entity Type:Organization
Organization Name:CASA ZEN ACUPUNCTURE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACUPUNCTURIST
Authorized Official - Prefix:
Authorized Official - First Name:JEANETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:CARRANZA ISLAS
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, MSTOM
Authorized Official - Phone:619-925-2017
Mailing Address - Street 1:1129 PACIFIC GROVE LOOP
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91915-2114
Mailing Address - Country:US
Mailing Address - Phone:619-587-2331
Mailing Address - Fax:
Practice Address - Street 1:4190 BONITA RD STE 209
Practice Address - Street 2:
Practice Address - City:BONITA
Practice Address - State:CA
Practice Address - Zip Code:91902-1340
Practice Address - Country:US
Practice Address - Phone:619-925-2017
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-26
Last Update Date:2019-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty