Provider Demographics
NPI:1831238757
Name:TSU, ANNA LAGIOS (LAC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:LAGIOS
Last Name:TSU
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 SONOMA AVE
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95815-1242
Mailing Address - Country:US
Mailing Address - Phone:916-922-4188
Mailing Address - Fax:916-922-4188
Practice Address - Street 1:1030 SONOMA AVE
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95815-1242
Practice Address - Country:US
Practice Address - Phone:916-508-8893
Practice Address - Fax:916-922-4188
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7146171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist