Provider Demographics
NPI:1760975155
Name:ZHANG, AMY JIAHUA (LAC)
Entity Type:Individual
Prefix:
First Name:AMY JIAHUA
Middle Name:
Last Name:ZHANG
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 1:2101 W CHAPMAN AVE STE B
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-2350
Mailing Address - Country:US
Mailing Address - Phone:714-978-8899
Mailing Address - Fax:714-242-1479
Practice Address - Street 1:2101 W CHAPMAN AVE STE B
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-2350
Practice Address - Country:US
Practice Address - Phone:714-978-8899
Practice Address - Fax:714-242-1479
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC4232171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC4232OtherACUPUNCTURE