Provider Demographics
NPI:1679978399
Name:MUNSON, JAMES (DAOM, LAC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:MUNSON
Suffix:
Gender:M
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:MICHAEL
Other - Last Name:MUNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DAOM, LAC
Mailing Address - Street 1:3173 RITA CT
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3317
Mailing Address - Country:US
Mailing Address - Phone:850-322-8708
Mailing Address - Fax:
Practice Address - Street 1:2180 JEFFERSON ST
Practice Address - Street 2:SUITE 105
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94559-1250
Practice Address - Country:US
Practice Address - Phone:707-418-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15040171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist