Provider Demographics
NPI:1922182658
Name:RICE, HEATHER LORRAINE (LAC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LORRAINE
Last Name:RICE
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 1:323 AVENIDA MONTEREY
Mailing Address - Street 2:APT C
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-6647
Mailing Address - Country:US
Mailing Address - Phone:949-940-0233
Mailing Address - Fax:
Practice Address - Street 1:34085 PACIFIC COAST HWY STE 205
Practice Address - Street 2:
Practice Address - City:DANA POINT
Practice Address - State:CA
Practice Address - Zip Code:92629-2765
Practice Address - Country:US
Practice Address - Phone:323-228-0024
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2008-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8567171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist