Provider Demographics
NPI:1154566917
Name:CHENEY, BAMBIE LYNNE (LAC)
Entity type:Individual
Prefix:MS
First Name:BAMBIE
Middle Name:LYNNE
Last Name:CHENEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:21731 VENTURA BLVD
Mailing Address - Street 2:STE 360
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364
Mailing Address - Country:US
Mailing Address - Phone:818-314-2666
Mailing Address - Fax:818-704-6757
Practice Address - Street 1:21731 VENTURA BLVD
Practice Address - Street 2:STE 360
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364
Practice Address - Country:US
Practice Address - Phone:818-314-2666
Practice Address - Fax:818-704-6757
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9119171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist