Provider Demographics
NPI:1013296904
Name:DUSSUYER, JOELLE (LAC)
Entity Type:Individual
Prefix:
First Name:JOELLE
Middle Name:
Last Name:DUSSUYER
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 1:4328 18TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-2427
Mailing Address - Country:US
Mailing Address - Phone:415-558-8953
Mailing Address - Fax:415-552-3604
Practice Address - Street 1:4328 18TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-2427
Practice Address - Country:US
Practice Address - Phone:415-558-8953
Practice Address - Fax:415-552-3604
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3227171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist