Provider Demographics
NPI:1669101473
Name:SENECHAL, CORINNE WELDER (LAC)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:WELDER
Last Name:SENECHAL
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 1:809 JUNIPER PL
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94945-1112
Mailing Address - Country:US
Mailing Address - Phone:415-684-7437
Mailing Address - Fax:
Practice Address - Street 1:809 JUNIPER PL
Practice Address - Street 2:
Practice Address - City:NOVATO
Practice Address - State:CA
Practice Address - Zip Code:94945-1112
Practice Address - Country:US
Practice Address - Phone:415-684-7437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19115171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist