Provider Demographics
NPI:1306017363
Name:PAUS, DESIREE MARIE-BELLE (LAC, HHP, MS, AS)
Entity type:Individual
Prefix:MS
First Name:DESIREE
Middle Name:MARIE-BELLE
Last Name:PAUS
Suffix:
Gender:F
Credentials:LAC, HHP, MS, AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4632 OREGON ST APT 5
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92116-6007
Mailing Address - Country:US
Mailing Address - Phone:619-518-8740
Mailing Address - Fax:619-255-8727
Practice Address - Street 1:4632 OREGON ST
Practice Address - Street 2:# 5
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92116-6006
Practice Address - Country:US
Practice Address - Phone:619-518-8740
Practice Address - Fax:619-255-8727
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11330171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist