Provider Demographics
NPI:1780919720
Name:TIGAN, EVA REGINA (LAC)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:REGINA
Last Name:TIGAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:EVI
Other - Middle Name:REGINA
Other - Last Name:TIGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:132 PALO VERDE TER
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-3225
Mailing Address - Country:US
Mailing Address - Phone:831-234-2608
Mailing Address - Fax:
Practice Address - Street 1:1509 SEABRIGHT AVE STE B2
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2555
Practice Address - Country:US
Practice Address - Phone:831-234-2608
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13349171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist