Provider Demographics
NPI:1073751533
Name:CHANG, JAMIE O (LAC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:O
Last Name:CHANG
Suffix:
Gender:F
Credentials:LAC
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Mailing Address - Street 1:8840 WARNER AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-3232
Mailing Address - Country:US
Mailing Address - Phone:714-841-1500
Mailing Address - Fax:714-841-1551
Practice Address - Street 1:8840 WARNER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-3232
Practice Address - Country:US
Practice Address - Phone:714-841-1500
Practice Address - Fax:714-841-1551
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2013-10-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAAC12718171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist