Provider Demographics
NPI:1811661085
Name:HANSEN, ROWAN ASHLEY LINDENFELD (LAC)
Entity type:Individual
Prefix:
First Name:ROWAN
Middle Name:ASHLEY LINDENFELD
Last Name:HANSEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:ROWAN
Other - Middle Name:
Other - Last Name:LINDENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC, MTCM/DTCM
Mailing Address - Street 1:624 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2203
Mailing Address - Country:US
Mailing Address - Phone:831-325-3922
Mailing Address - Fax:
Practice Address - Street 1:624 FREDERICK ST
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2203
Practice Address - Country:US
Practice Address - Phone:831-325-3922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-02
Last Update Date:2023-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19187305S00000X
CA19187171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No305S00000XManaged Care OrganizationsPoint of Service