Provider Demographics
NPI:1689929408
Name:WHIPPLE, MARGARET RANDOLPH (LAC)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:RANDOLPH
Last Name:WHIPPLE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:MRS
Other - First Name:MARGARET
Other - Middle Name:WHIPPLE
Other - Last Name:ODA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:24307 MAGIC MOUNTAIN PKWY
Mailing Address - Street 2:230
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3402
Mailing Address - Country:US
Mailing Address - Phone:818-731-0842
Mailing Address - Fax:
Practice Address - Street 1:22812 SOLEDAD CANYON RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-2630
Practice Address - Country:US
Practice Address - Phone:818-731-0842
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-18
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3965171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist