Provider Demographics
NPI:1487102562
Name:CHAVES, NAIMA (LAC)
Entity type:Individual
Prefix:MS
First Name:NAIMA
Middle Name:
Last Name:CHAVES
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 1:846 OAK GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-4422
Mailing Address - Country:US
Mailing Address - Phone:650-703-3836
Mailing Address - Fax:
Practice Address - Street 1:846 OAK GROVE AVE
Practice Address - Street 2:
Practice Address - City:MENLO PARK
Practice Address - State:CA
Practice Address - Zip Code:94025-4422
Practice Address - Country:US
Practice Address - Phone:650-703-3836
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15333171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist