Provider Demographics
NPI:1215053079
Name:BECKER-OLLER, ANNETTE B (LAC)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:B
Last Name:BECKER-OLLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ANNETTE
Other - Middle Name:B
Other - Last Name:OLLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LA C
Mailing Address - Street 1:50 CLAYPOOL CT
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4320
Mailing Address - Country:US
Mailing Address - Phone:925-324-0196
Mailing Address - Fax:
Practice Address - Street 1:50 CLAYPOOL CT
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4320
Practice Address - Country:US
Practice Address - Phone:925-324-0196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3736171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist