CA Wall License 1639 Information
| Name | Tisa Anderson |
| License Number | 1639 |
| Individual or Organization | O |
| Address | 804 Pier View Way Ste. 200
Oceanside, CA 92054 |
| County | San Diego |
| License Status | Active |
| License Original Issue Date | 4/25/2014 |
| License Expiration Date | 9/30/2023 |
| License Type | Wall License |
| Agency | Acupuncture Board |