Provider Demographics
NPI:1659707198
Name:URBASSEK, DANIELA CHRISTINE (LAC)
Entity Type:Individual
Prefix:
First Name:DANIELA
Middle Name:CHRISTINE
Last Name:URBASSEK
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:PO BOX 221741
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93922-1741
Mailing Address - Country:US
Mailing Address - Phone:831-521-1117
Mailing Address - Fax:
Practice Address - Street 1:3855 VIA NONA MARIE
Practice Address - Street 2:SUITE 202C
Practice Address - City:CARMEL
Practice Address - State:CA
Practice Address - Zip Code:93923-8614
Practice Address - Country:US
Practice Address - Phone:831-521-1117
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 14560171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist