Provider Demographics
NPI:1669985834
Name:BABAT, DEVIN ANNE (MTCM, CMT)
Entity type:Individual
Prefix:
First Name:DEVIN
Middle Name:ANNE
Last Name:BABAT
Suffix:
Gender:F
Credentials:MTCM, CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39800 FREMONT BLVD APT 313
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-2670
Mailing Address - Country:US
Mailing Address - Phone:971-678-1614
Mailing Address - Fax:
Practice Address - Street 1:851 FREMONT AVE STE 111
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5602
Practice Address - Country:US
Practice Address - Phone:971-678-1614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17923171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist