Provider Demographics
NPI:1033584206
Name:ECO CENTER FOR EDUCATION AND WELLNESS
Entity Type:Organization
Organization Name:ECO CENTER FOR EDUCATION AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-380-8555
Mailing Address - Street 1:1110 S EL CAMINO REAL
Mailing Address - Street 2:2
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-2893
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1110 S EL CAMINO REAL
Practice Address - Street 2:2
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-2893
Practice Address - Country:US
Practice Address - Phone:408-641-0689
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-14
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15591171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty