Provider Demographics
NPI:1770509481
Name:HASPER, ALICIA ESTHER (L AC)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:ESTHER
Last Name:HASPER
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 VALENCIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3026
Mailing Address - Country:US
Mailing Address - Phone:415-647-6222
Mailing Address - Fax:415-695-7615
Practice Address - Street 1:1193 VALENCIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3026
Practice Address - Country:US
Practice Address - Phone:415-647-6222
Practice Address - Fax:415-695-7615
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4274171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC0042740Medicaid