Provider Demographics
NPI:1700684461
Name:HACKMAN, AUBREY (LAC)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:
Last Name:HACKMAN
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 1:1047 GOLDEN RD APT B
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4677
Mailing Address - Country:US
Mailing Address - Phone:970-708-9631
Mailing Address - Fax:
Practice Address - Street 1:977 LOMAS SANTA FE DR STE D
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-2134
Practice Address - Country:US
Practice Address - Phone:858-481-1438
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
19827171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist