CA Wall License 1622 Information
| Name | Stephanie La Carrubba |
| License Number | 1622 |
| Individual or Organization | O |
| Address | 430 Peninsula Ave. #3
San Mateo, CA 94401 |
| County | San Mateo |
| License Status | Active |
| License Original Issue Date | 8/27/1996 |
| License Expiration Date | 9/30/2023 |
| License Type | Wall License |
| Agency | Acupuncture Board |