Provider Demographics
NPI:1922122308
Name:KING, VANESSA SIVIGLIA (L AC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:SIVIGLIA
Last Name:KING
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 1:77-6456 KILOHANA ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-9743
Mailing Address - Country:US
Mailing Address - Phone:808-896-8705
Mailing Address - Fax:
Practice Address - Street 1:77-6456 KILOHANA ST
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-9743
Practice Address - Country:US
Practice Address - Phone:808-896-8705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU-678171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist