| Doctor Name: | ANNA LIZA VAN DINE |
| NPI Number: | 1023495629 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.AC. |
| License Number: | 28538 |
| Business Practice Address: | 2801 Mission St. Ext Suite 2805 Santa Cruz, CA - 95060 |
| Business Phone Number: | 8559469264 |
| Business Fax Number: | 8558263463 |
| Mailing Address: | 2636 17th Ave # 112, SANTA CRUZ |
| State: | CA |
| Postal Code: | 950651808 |
| Phone Number: | 8559469264 |
| Fax Number: | 8558263463 |
| NPI Enumeration Date: | 05/03/2015 |
| NPI Last Update Date: | 10/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225700000X |
| License Number: | 28538 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Massage Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |