Provider Demographics
NPI:1144569427
Name:JIA YANG ACUPUNCTURE CLINIC, INC
Entity Type:Organization
Organization Name:JIA YANG ACUPUNCTURE CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JIA
Authorized Official - Middle Name:
Authorized Official - Last Name:YANG
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:925-339-1548
Mailing Address - Street 1:4460 BLACK AVE STE I
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6139
Mailing Address - Country:US
Mailing Address - Phone:925-339-1548
Mailing Address - Fax:815-346-2482
Practice Address - Street 1:4460 BLACK AVE STE I
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-6139
Practice Address - Country:US
Practice Address - Phone:925-339-1548
Practice Address - Fax:815-346-2482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-07
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC7920171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty