Provider Demographics
NPI:1902183973
Name:ANG-VONG, VERONICA (LAC, DIPLOM)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:ANG-VONG
Suffix:
Gender:F
Credentials:LAC, DIPLOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4341 PIEDMONT AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94611-4766
Mailing Address - Country:US
Mailing Address - Phone:510-597-9923
Mailing Address - Fax:
Practice Address - Street 1:4341 PIEDMONT AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94611-4766
Practice Address - Country:US
Practice Address - Phone:510-597-9923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11335171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist