Provider Demographics
NPI:1679190714
Name:WU, WENCE (DAOM, LAC)
Entity Type:Individual
Prefix:DR
First Name:WENCE
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:DAOM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39812 MISSION BLVD STE 220
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3092
Mailing Address - Country:US
Mailing Address - Phone:510-605-8900
Mailing Address - Fax:
Practice Address - Street 1:39812 MISSION BLVD STE 220
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3092
Practice Address - Country:US
Practice Address - Phone:510-605-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-05
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18015171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist