Provider Demographics
NPI:1184940504
Name:VAN LIEROP, CINDA DANIELLE (LAC, MSTCM)
Entity type:Individual
Prefix:MS
First Name:CINDA
Middle Name:DANIELLE
Last Name:VAN LIEROP
Suffix:
Gender:F
Credentials:LAC, MSTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BON AIR RD STE 127
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1139
Mailing Address - Country:US
Mailing Address - Phone:415-596-1600
Mailing Address - Fax:415-523-9881
Practice Address - Street 1:5 BON AIR RD STE 127
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1139
Practice Address - Country:US
Practice Address - Phone:415-596-1600
Practice Address - Fax:415-523-9881
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13606171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist