Provider Demographics
NPI:1659693810
Name:YANG, WEI (LAC)
Entity Type:Individual
Prefix:
First Name:WEI
Middle Name:
Last Name:YANG
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 1:39 BIRCH ST STE B
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-1483
Mailing Address - Country:US
Mailing Address - Phone:650-503-9562
Mailing Address - Fax:
Practice Address - Street 1:39 BIRCH ST STE B
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-1483
Practice Address - Country:US
Practice Address - Phone:650-503-9562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-15
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60066502171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL100249OtherNATIONAL CERTIFICATION COMMISSION FOR ACUPUNCTURE AND ORIENTAL MEDICINE
WAAC 60066502OtherWASHINGTON STATE DEPARTMENT OF HEALTH
NY003698OtherNEW YORK STATE