Provider Demographics
NPI:1336781590
Name:LE, CECILIA TRANG (LAC)
Entity Type:Individual
Prefix:
First Name:CECILIA
Middle Name:TRANG
Last Name:LE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 N PARK VICTORIA DR
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-4613
Mailing Address - Country:US
Mailing Address - Phone:408-799-6658
Mailing Address - Fax:
Practice Address - Street 1:1288 KIFER RD STE 202
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-5326
Practice Address - Country:US
Practice Address - Phone:408-858-7808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-09
Last Update Date:2019-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18716171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist