Provider Demographics
NPI:1669215166
Name:TRAPANI, DANIELLE (DACM LAC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:TRAPANI
Suffix:
Gender:F
Credentials:DACM LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1184 DOT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-8266
Mailing Address - Country:US
Mailing Address - Phone:530-721-9016
Mailing Address - Fax:
Practice Address - Street 1:2494 LAKE TAHOE BLVD STE B6
Practice Address - Street 2:
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-7142
Practice Address - Country:US
Practice Address - Phone:530-721-9016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist