Provider Demographics
NPI:1841517174
Name:NOVAK, ELIZABETH ANNE (RN, LAC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:NOVAK
Suffix:
Gender:F
Credentials:RN, LAC
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Mailing Address - Street 1:9779 W CANYON TER
Mailing Address - Street 2:#1
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4680
Mailing Address - Country:US
Mailing Address - Phone:858-569-6948
Mailing Address - Fax:858-569-6948
Practice Address - Street 1:9779 W CANYON TER
Practice Address - Street 2:#1
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4680
Practice Address - Country:US
Practice Address - Phone:858-569-6948
Practice Address - Fax:858-569-6948
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA13134171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist