Provider Demographics
NPI:1073673356
Name:DUTTER, KRISSELL ELIZABETH (L AC)
Entity type:Individual
Prefix:MRS
First Name:KRISSELL
Middle Name:ELIZABETH
Last Name:DUTTER
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:393 W LOMITA AVE
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2244
Mailing Address - Country:US
Mailing Address - Phone:805-218-9851
Mailing Address - Fax:
Practice Address - Street 1:393 W LOMITA AVE
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2244
Practice Address - Country:US
Practice Address - Phone:805-218-9851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAT3439171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist