Provider Demographics
NPI:1053699801
Name:SALEH KASMAI, NIKOO ROSE (LAC)
Entity type:Individual
Prefix:MS
First Name:NIKOO
Middle Name:ROSE
Last Name:SALEH KASMAI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MS
Other - First Name:NIKOO
Other - Middle Name:
Other - Last Name:KASMAI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:110 LA CASA VIA
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3088
Mailing Address - Country:US
Mailing Address - Phone:925-567-3337
Mailing Address - Fax:
Practice Address - Street 1:110 LA CASA VIA
Practice Address - Street 2:SUITE 200
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3088
Practice Address - Country:US
Practice Address - Phone:925-567-3337
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-28
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14042171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist