Provider Demographics
NPI:1497067730
Name:JANG, JEONHEE
Entity Type:Individual
Prefix:
First Name:JEONHEE
Middle Name:
Last Name:JANG
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 1:490 POST ST
Mailing Address - Street 2:STE 1210
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1303
Mailing Address - Country:US
Mailing Address - Phone:925-200-4669
Mailing Address - Fax:
Practice Address - Street 1:490 POST ST
Practice Address - Street 2:STE 1210
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1303
Practice Address - Country:US
Practice Address - Phone:925-200-4669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2015-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13459171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist