Provider Demographics
NPI:1477343234
Name:MOUA, TSWJFWM NAOLUE (LAC)
Entity type:Individual
Prefix:
First Name:TSWJFWM
Middle Name:NAOLUE
Last Name:MOUA
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:TOUFU
Other - Middle Name:TSWJFWM NAOLUE
Other - Last Name:MOUA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:638 PHELPS DR
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95348-9612
Mailing Address - Country:US
Mailing Address - Phone:951-486-1541
Mailing Address - Fax:
Practice Address - Street 1:301 W 18TH ST STE 203B
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95340-4831
Practice Address - Country:US
Practice Address - Phone:951-486-1541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-07
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34467111N00000X
CA15689171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No111N00000XChiropractic ProvidersChiropractor