Provider Demographics
NPI:1316013303
Name:WANG, SHINING
Entity Type:Individual
Prefix:
First Name:SHINING
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 LAKESIDE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4005
Mailing Address - Country:US
Mailing Address - Phone:408-530-8989
Mailing Address - Fax:408-530-8139
Practice Address - Street 1:542 LAKESIDE DR STE 1
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4005
Practice Address - Country:US
Practice Address - Phone:408-530-8989
Practice Address - Fax:408-530-8139
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9735171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist