Individual
GRACE ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
1325 E THOUSAND OAKS BLVD, SUITE 104, THOUSAND OAKS, CA 91362-2822
(805) 410-3160
Mailing address
107 N REINO RD # 211, NEWBURY PARK, CA 91320-3710
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC14876
CA
Other
Enumeration date
05/23/2012
Last updated
01/20/2016
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