Provider Demographics
NPI:1841435070
Name:FOLLINGSTAD, DEBORAH (LAC, CMQ, MSTCM)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:
Last Name:FOLLINGSTAD
Suffix:
Gender:F
Credentials:LAC, CMQ, MSTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 NEVADA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-5722
Mailing Address - Country:US
Mailing Address - Phone:415-572-5798
Mailing Address - Fax:
Practice Address - Street 1:55 FRANCISCO ST
Practice Address - Street 2:SUITE 700
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-2122
Practice Address - Country:US
Practice Address - Phone:415-682-0843
Practice Address - Fax:415-682-0843
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12686171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA271455407OtherNPI