Provider Demographics
NPI:1518039114
Name:CLIMENHAGA, RHODA (LAC)
Entity type:Individual
Prefix:MS
First Name:RHODA
Middle Name:
Last Name:CLIMENHAGA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4445 DAVENPORT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94619-2914
Mailing Address - Country:US
Mailing Address - Phone:510-306-0067
Mailing Address - Fax:
Practice Address - Street 1:411 30TH ST STE 304
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3303
Practice Address - Country:US
Practice Address - Phone:510-444-2772
Practice Address - Fax:510-444-2773
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8559171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist