Provider Demographics
NPI:1174648166
Name:LIN, JUEHUA (LAC, PHD)
Entity Type:Individual
Prefix:DR
First Name:JUEHUA
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:DR
Other - First Name:KOCK-WAH
Other - Middle Name:
Other - Last Name:LUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC, PHD
Mailing Address - Street 1:388 9TH ST
Mailing Address - Street 2:SUITE 216
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-4287
Mailing Address - Country:US
Mailing Address - Phone:510-465-4599
Mailing Address - Fax:510-465-3469
Practice Address - Street 1:388 9TH ST
Practice Address - Street 2:SUITE 216
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-4287
Practice Address - Country:US
Practice Address - Phone:510-465-4599
Practice Address - Fax:510-465-3469
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC3080171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist