Provider Demographics
NPI:1891464285
Name:LEDOUX, CHRISTINA (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:LEDOUX
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 1:88 E BAY STATE ST UNIT 3F
Mailing Address - Street 2:
Mailing Address - City:ALHAMBRA
Mailing Address - State:CA
Mailing Address - Zip Code:91801-6824
Mailing Address - Country:US
Mailing Address - Phone:626-999-1163
Mailing Address - Fax:
Practice Address - Street 1:30 N RAYMOND AVE STE 811
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91103-4480
Practice Address - Country:US
Practice Address - Phone:626-999-1163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19132171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist