Provider Demographics
NPI:1114500428
Name:YE, JIAXIN
Entity Type:Individual
Prefix:
First Name:JIAXIN
Middle Name:
Last Name:YE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 INDUSTRIAL PKWY W
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94544-7046
Mailing Address - Country:US
Mailing Address - Phone:510-364-6666
Mailing Address - Fax:
Practice Address - Street 1:1629 INDUSTRIAL PKWY W
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94544-7046
Practice Address - Country:US
Practice Address - Phone:510-364-6666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-04
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19085171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist