Provider Demographics
NPI:1700251097
Name:CASSONE, JOHN (PHD, LAC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:CASSONE
Suffix:
Gender:M
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28465 OLD TOWN FRONT ST
Mailing Address - Street 2:SUITE 324
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-1819
Mailing Address - Country:US
Mailing Address - Phone:951-693-9355
Mailing Address - Fax:
Practice Address - Street 1:28465 OLD TOWN FRONT ST
Practice Address - Street 2:SUITE 324
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-1819
Practice Address - Country:US
Practice Address - Phone:951-693-9355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-11
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16743171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist