Provider Demographics
NPI:1922303114
Name:ELSNER, BARBARA WALLACE (LAC)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:WALLACE
Last Name:ELSNER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:13 W AVENIDA CORNELIO
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-3259
Mailing Address - Country:US
Mailing Address - Phone:949-492-0898
Mailing Address - Fax:
Practice Address - Street 1:675 CAMINO DE LOS MARES STE 303
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92673-2837
Practice Address - Country:US
Practice Address - Phone:949-374-3114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13851171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist