Provider Demographics
NPI:1912063553
Name:TRAUGHBER, DADRE DEANNE (L AC)
Entity Type:Individual
Prefix:MS
First Name:DADRE
Middle Name:DEANNE
Last Name:TRAUGHBER
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:870 MARKET STREET
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102
Mailing Address - Country:US
Mailing Address - Phone:415-397-0700
Mailing Address - Fax:415-397-6805
Practice Address - Street 1:870 MARKET STREET
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102
Practice Address - Country:US
Practice Address - Phone:415-397-0700
Practice Address - Fax:415-397-6805
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4335171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist