Provider Demographics
NPI:1700175502
Name:WU, JOYCE X (LAC)
Entity Type:Individual
Prefix:
First Name:JOYCE
Middle Name:X
Last Name:WU
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 1:3725 LONE TREE WAY
Mailing Address - Street 2:SUITE D-2
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509
Mailing Address - Country:US
Mailing Address - Phone:925-757-9012
Mailing Address - Fax:925-757-9174
Practice Address - Street 1:3725 LONE TREE WAY
Practice Address - Street 2:SUITE D-2
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509
Practice Address - Country:US
Practice Address - Phone:925-757-9012
Practice Address - Fax:925-757-9174
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC14078171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist