Provider Demographics
NPI:1033674411
Name:JJ HEALTH RENEWAL
Entity Type:Organization
Organization Name:JJ HEALTH RENEWAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JIURU
Authorized Official - Middle Name:
Authorized Official - Last Name:XIE
Authorized Official - Suffix:
Authorized Official - Credentials:ACUPUNCTURIST
Authorized Official - Phone:626-202-3935
Mailing Address - Street 1:7655 MASTERS ST
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7245
Mailing Address - Country:US
Mailing Address - Phone:626-202-3935
Mailing Address - Fax:
Practice Address - Street 1:7485 RUSH RIVER DR STE 750
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-5261
Practice Address - Country:US
Practice Address - Phone:916-389-0489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-09
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073793634OtherACUPUNCTURE
1083867733OtherACUPUNCTURE