Provider Demographics
NPI:1093444028
Name:CERNA, KRISTEN (DACM, LAC)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:CERNA
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:
Other - Last Name:MAURER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DACM, LAC
Mailing Address - Street 1:885 REQUEZA ST
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3838
Mailing Address - Country:US
Mailing Address - Phone:513-607-8283
Mailing Address - Fax:
Practice Address - Street 1:451 LA VETA AVE
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-2014
Practice Address - Country:US
Practice Address - Phone:760-652-1116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19422171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist