Provider Demographics
NPI:1780821223
Name:WONG, LISA KAR YING (L AC)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:KAR YING
Last Name:WONG
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 10323
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95157-1323
Mailing Address - Country:US
Mailing Address - Phone:408-337-2887
Mailing Address - Fax:408-890-4689
Practice Address - Street 1:18988 COX AVE STE C
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-4154
Practice Address - Country:US
Practice Address - Phone:408-337-2887
Practice Address - Fax:408-890-4689
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2011-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 12665171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist