Provider Demographics
NPI:1154674455
Name:YANG, YUANSHU (TCM)
Entity type:Individual
Prefix:
First Name:YUANSHU
Middle Name:
Last Name:YANG
Suffix:
Gender:F
Credentials:TCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3767 VINEYARD AVE APT 9
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6862
Mailing Address - Country:US
Mailing Address - Phone:415-690-9329
Mailing Address - Fax:
Practice Address - Street 1:1615 N BROADWAY
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4222
Practice Address - Country:US
Practice Address - Phone:415-690-9329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-24
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15004171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist