Provider Demographics
NPI:1295249258
Name:KIERI, SOPHIA CUEVAS (L AC)
Entity type:Individual
Prefix:
First Name:SOPHIA
Middle Name:CUEVAS
Last Name:KIERI
Suffix:
Gender:F
Credentials:L AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1957 CAPE HORN DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95133-1511
Mailing Address - Country:US
Mailing Address - Phone:408-396-7004
Mailing Address - Fax:
Practice Address - Street 1:6055 MERIDIAN AVE STE 30
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95120-2700
Practice Address - Country:US
Practice Address - Phone:408-766-1811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-28
Last Update Date:2018-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC17878171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist