Provider Demographics
NPI:1780828384
Name:APPENZELLER, ERICA DAWN (LAC)
Entity type:Individual
Prefix:MS
First Name:ERICA
Middle Name:DAWN
Last Name:APPENZELLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:ERICA
Other - Middle Name:DAWN
Other - Last Name:APPENZELLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:4032 VALETA ST UNIT 315
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-5818
Mailing Address - Country:US
Mailing Address - Phone:619-549-4964
Mailing Address - Fax:
Practice Address - Street 1:3555 KENYON ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-5341
Practice Address - Country:US
Practice Address - Phone:619-549-4964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2024-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12711171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist