Provider Demographics
NPI:1356834709
Name:VELEZ, KARA MARIE (LAC)
Entity type:Individual
Prefix:
First Name:KARA
Middle Name:MARIE
Last Name:VELEZ
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 28882
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92198-0882
Mailing Address - Country:US
Mailing Address - Phone:619-995-0966
Mailing Address - Fax:619-431-2257
Practice Address - Street 1:16776 BERNARDO CENTER DR STE 211
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92128-2559
Practice Address - Country:US
Practice Address - Phone:619-995-0966
Practice Address - Fax:619-431-2257
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18131171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist