Provider Demographics
NPI:1811021900
Name:NEWELL, FAITH KATHLEEN (LAC)
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:KATHLEEN
Last Name:NEWELL
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 1:411 DAYLOMA AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2011
Mailing Address - Country:US
Mailing Address - Phone:805-642-1873
Mailing Address - Fax:
Practice Address - Street 1:411 DAYLOMA AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2011
Practice Address - Country:US
Practice Address - Phone:805-642-1873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 7108171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist