Provider Demographics
NPI:1972187284
Name:LA JOLLA ONCOLOGY ACUPUNCTURE & MASSAGE
Entity Type:Organization
Organization Name:LA JOLLA ONCOLOGY ACUPUNCTURE & MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:FRANCES JEANSONNE
Authorized Official - Last Name:PAUSEBACK
Authorized Official - Suffix:
Authorized Official - Credentials:DACM, LAC
Authorized Official - Phone:858-224-3690
Mailing Address - Street 1:7855 IVANHOE AVE STE 212
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-4508
Mailing Address - Country:US
Mailing Address - Phone:858-224-3690
Mailing Address - Fax:
Practice Address - Street 1:7855 IVANHOE AVE STE 212
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4508
Practice Address - Country:US
Practice Address - Phone:858-224-3690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-12
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty