Provider Demographics
NPI:1497101141
Name:XU, SASHUANG (PHD)
Entity Type:Individual
Prefix:DR
First Name:SASHUANG
Middle Name:
Last Name:XU
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:SASHUANG
Other - Middle Name:
Other - Last Name:WU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:824 SNAPPER TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94536-3258
Mailing Address - Country:US
Mailing Address - Phone:510-999-2678
Mailing Address - Fax:
Practice Address - Street 1:650 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94536-4113
Practice Address - Country:US
Practice Address - Phone:510-999-2678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC16987171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist