Provider Demographics
NPI:1144598988
Name:ONAN, TERESA (LAC, LMT)
Entity type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:ONAN
Suffix:
Gender:F
Credentials:LAC, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1149 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-5024
Mailing Address - Country:US
Mailing Address - Phone:858-733-0832
Mailing Address - Fax:619-440-9440
Practice Address - Street 1:1149 N 2ND ST
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92021-5024
Practice Address - Country:US
Practice Address - Phone:858-733-0832
Practice Address - Fax:619-440-9440
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-08
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CABC-006697173C00000X
CA15303171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No173C00000XOther Service ProvidersReflexologist