Provider Demographics
NPI:1013300086
Name:USHIJIMA, JOCELYN CHUNGLEI
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:CHUNGLEI
Last Name:USHIJIMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12391 OAK WAY DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-4650
Mailing Address - Country:US
Mailing Address - Phone:562-760-7250
Mailing Address - Fax:
Practice Address - Street 1:12391 OAK WAY DR
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-4650
Practice Address - Country:US
Practice Address - Phone:562-760-7250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-13
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16373171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist