Provider Demographics
NPI:1356552020
Name:ABOVSKY, DIANA (LAC)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:
Last Name:ABOVSKY
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 1:1254 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-1335
Mailing Address - Country:US
Mailing Address - Phone:415-928-6198
Mailing Address - Fax:415-946-3323
Practice Address - Street 1:101 HOWARD ST
Practice Address - Street 2:GROUND LEVEL
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94105-1629
Practice Address - Country:US
Practice Address - Phone:415-867-4441
Practice Address - Fax:415-946-3323
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11764171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist