Provider Demographics
NPI:1316466980
Name:PRICE, GENEVIEVE LARA (ND)
Entity type:Individual
Prefix:MISS
First Name:GENEVIEVE
Middle Name:LARA
Last Name:PRICE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4110 SORRENTO VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1429
Mailing Address - Country:US
Mailing Address - Phone:858-246-9730
Mailing Address - Fax:
Practice Address - Street 1:4110 SORRENTO VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1429
Practice Address - Country:US
Practice Address - Phone:858-246-9730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-15
Last Update Date:2017-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath