Provider Demographics
NPI:1831138643
Name:ABRAMS, SALLY N (LAC)
Entity Type:Individual
Prefix:MS
First Name:SALLY
Middle Name:N
Last Name:ABRAMS
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 1:138 CORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5504
Mailing Address - Country:US
Mailing Address - Phone:415-824-6216
Mailing Address - Fax:415-282-2989
Practice Address - Street 1:138 CORTLAND AVE
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5504
Practice Address - Country:US
Practice Address - Phone:415-824-6216
Practice Address - Fax:415-282-2989
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2665171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist