Provider Demographics
NPI:1306071105
Name:PRICE, NINA
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LAC
Mailing Address - Street 1:4161 EL CAMINO WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-4006
Mailing Address - Country:US
Mailing Address - Phone:650-424-8783
Mailing Address - Fax:650-424-8783
Practice Address - Street 1:4161 EL CAMINO WAY
Practice Address - Street 2:SUITE A
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-4006
Practice Address - Country:US
Practice Address - Phone:650-424-8783
Practice Address - Fax:650-424-8783
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12532171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist