Provider Demographics
NPI:1699907931
Name:LODEN, CHRISTINA M (LAC)
Entity type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:M
Last Name:LODEN
Suffix:
Gender:F
Credentials:LAC
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Mailing Address - Street 1:12963 RUNWAY RD
Mailing Address - Street 2:#416
Mailing Address - City:PLAYA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:90094-2198
Mailing Address - Country:US
Mailing Address - Phone:310-570-9723
Mailing Address - Fax:
Practice Address - Street 1:777 SILVER SPUR RD
Practice Address - Street 2:#112
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3633
Practice Address - Country:US
Practice Address - Phone:310-570-9723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-20
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12304171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist