Provider Demographics
NPI:1457750002
Name:MCCAULEY, ELEANOR ELIZABETH (LAC)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:ELIZABETH
Last Name:MCCAULEY
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 1:915 IRVING ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94122-2206
Mailing Address - Country:US
Mailing Address - Phone:415-846-7636
Mailing Address - Fax:415-661-7371
Practice Address - Street 1:915 IRVING ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94122-2206
Practice Address - Country:US
Practice Address - Phone:415-846-7636
Practice Address - Fax:415-661-7371
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14028171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist