Edens-Tan, Lisa

Edens-Tan, Lisa is an individual health care provider with primary practice located at 647 N Main St , Fort Bragg CA 95437-3219. She recently has only one registered license in Other Service Providers / Naturopath, which is considered as her primary health care specialty. Edens-Tan, Lisa can be contacted via phone (925) 209-5966.

Contact Information

Primary practice address
647 N Main St Fort Bragg CA 95437-3219
Phone: (925) 209-5966
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Naturopath 175F00000X ND988 California

Profile Details

NPI number 1316434442
LBN Legal business name Edens-Tan, Lisa
Credentials ND
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2018
Last updated Feb 4th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316434442 NPPES
California Other ND988 DEPARTMENT OF CONSUMER AFFAIRS

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