Provider Demographics
NPI:1891596326
Name:LAVOIE, DEREK KEVIN (DVM, LAC)
Entity type:Individual
Prefix:DR
First Name:DEREK
Middle Name:KEVIN
Last Name:LAVOIE
Suffix:
Gender:
Credentials:DVM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1054 COURTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6926
Mailing Address - Country:US
Mailing Address - Phone:805-305-1396
Mailing Address - Fax:
Practice Address - Street 1:1054 COURTLAND AVE
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-6926
Practice Address - Country:US
Practice Address - Phone:805-305-1396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-21
Last Update Date:2025-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20309171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist