Provider Demographics
NPI:1194864744
Name:JEW, KAREN ANN (LAC)
Entity type:Individual
Prefix:MISS
First Name:KAREN
Middle Name:ANN
Last Name:JEW
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:526 SOQUEL AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2321
Mailing Address - Country:US
Mailing Address - Phone:831-454-9641
Mailing Address - Fax:831-401-2310
Practice Address - Street 1:526 SOQUEL AVE
Practice Address - Street 2:SUITE D
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2321
Practice Address - Country:US
Practice Address - Phone:831-454-9641
Practice Address - Fax:831-401-2310
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 8775171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist