Provider Demographics
NPI:1881946028
Name:FIALK, JAMES LANGAN (LAC, ND)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LANGAN
Last Name:FIALK
Suffix:
Gender:M
Credentials:LAC, ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ORETSKY WAY
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-5327
Mailing Address - Country:US
Mailing Address - Phone:707-548-8522
Mailing Address - Fax:
Practice Address - Street 1:130 PETALUMA AVE
Practice Address - Street 2:SUITE 2E
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4220
Practice Address - Country:US
Practice Address - Phone:707-492-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-12
Last Update Date:2020-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND626175F00000X
CA18651171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No175F00000XOther Service ProvidersNaturopath