Provider Demographics
NPI:1255957056
Name:TIAN, JINGZE
Entity type:Individual
Prefix:
First Name:JINGZE
Middle Name:
Last Name:TIAN
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 1:2226 YOSEMITE DR
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-6650
Mailing Address - Country:US
Mailing Address - Phone:216-206-9222
Mailing Address - Fax:
Practice Address - Street 1:200 JOSE FIGUERES AVE STE 325
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1592
Practice Address - Country:US
Practice Address - Phone:216-206-9222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-18
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered