Provider Demographics
NPI:1801195656
Name:HIGUCHI, KRISTINA MIKI (LAC)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:MIKI
Last Name:HIGUCHI
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 1:1140 LAUREL ST STE C
Mailing Address - Street 2:
Mailing Address - City:SAN CARLOS
Mailing Address - State:CA
Mailing Address - Zip Code:94070-5054
Mailing Address - Country:US
Mailing Address - Phone:408-600-1513
Mailing Address - Fax:
Practice Address - Street 1:1140 LAUREL ST STE C
Practice Address - Street 2:
Practice Address - City:SAN CARLOS
Practice Address - State:CA
Practice Address - Zip Code:94070-5054
Practice Address - Country:US
Practice Address - Phone:408-600-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-19
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14131171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist