Provider Demographics
NPI:1255457362
Name:LUONG, FAYE HESTER (LAC)
Entity type:Individual
Prefix:MRS
First Name:FAYE
Middle Name:HESTER
Last Name:LUONG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2655 CARLO SCIMECA DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95132-2609
Mailing Address - Country:US
Mailing Address - Phone:408-712-0201
Mailing Address - Fax:
Practice Address - Street 1:3097 MOORPARK AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2543
Practice Address - Country:US
Practice Address - Phone:408-260-2458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9647171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist