Provider Demographics
NPI:1376971325
Name:BAI, SHAOYING GRACE (LAC)
Entity Type:Individual
Prefix:MS
First Name:SHAOYING
Middle Name:GRACE
Last Name:BAI
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 BUTANO DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0657
Mailing Address - Country:US
Mailing Address - Phone:916-612-6841
Mailing Address - Fax:916-487-2856
Practice Address - Street 1:2322 BUTANO DRIVE
Practice Address - Street 2:STE. 210A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825
Practice Address - Country:US
Practice Address - Phone:916-483-2283
Practice Address - Fax:916-487-2856
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-29
Last Update Date:2023-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC6125171100000X, 171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist