Provider Demographics
NPI:1306148002
Name:ZACHARA, DENA (LAC, DIPL OM)
Entity type:Individual
Prefix:MS
First Name:DENA
Middle Name:
Last Name:ZACHARA
Suffix:
Gender:F
Credentials:LAC, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15142 MOORPARK ST
Mailing Address - Street 2:#202
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5411
Mailing Address - Country:US
Mailing Address - Phone:818-404-9212
Mailing Address - Fax:
Practice Address - Street 1:15142 MOORPARK ST
Practice Address - Street 2:#202
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5411
Practice Address - Country:US
Practice Address - Phone:818-404-9212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 9890171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist