Provider Demographics
NPI:1992488860
Name:ROST, ALLISON (LAC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ROST
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 CLAY ST APT 304
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-3433
Mailing Address - Country:US
Mailing Address - Phone:724-309-6326
Mailing Address - Fax:
Practice Address - Street 1:1000 5TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-6103
Practice Address - Country:US
Practice Address - Phone:724-309-6326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19811171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist