Provider Demographics
NPI:1982907127
Name:CAPINA, LAURA (PHD,LAC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CAPINA
Suffix:
Gender:F
Credentials:PHD,LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FATHOM DR
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1417
Mailing Address - Country:US
Mailing Address - Phone:714-713-4531
Mailing Address - Fax:
Practice Address - Street 1:1601 DOVE ST STE 190
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-2441
Practice Address - Country:US
Practice Address - Phone:714-713-4531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-09
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC12131171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist