Provider Demographics
NPI:1225354509
Name:HE, JIAN YU (L AC)
Entity Type:Individual
Prefix:
First Name:JIAN YU
Middle Name:
Last Name:HE
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 COLLINS DR
Mailing Address - Street 2:STE. B
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-3132
Mailing Address - Country:US
Mailing Address - Phone:209-383-2225
Mailing Address - Fax:
Practice Address - Street 1:3170 COLLINS DR
Practice Address - Street 2:STE. B
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95348-3132
Practice Address - Country:US
Practice Address - Phone:209-383-2225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-12
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 13507171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist