Provider Demographics
NPI:1578244836
Name:HUANG, EILEEN WEI (LAC)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:WEI
Last Name:HUANG
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 1:4127 HEIRLOOM LN
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95377-8732
Mailing Address - Country:US
Mailing Address - Phone:209-227-3867
Mailing Address - Fax:
Practice Address - Street 1:4127 HEIRLOOM LN
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95377-8732
Practice Address - Country:US
Practice Address - Phone:209-227-3867
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19769171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist