Provider Demographics
NPI:1720649023
Name:ZHUANG, JIAJIA
Entity Type:Individual
Prefix:
First Name:JIAJIA
Middle Name:
Last Name:ZHUANG
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 1:333 W MAUDE AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94085-4367
Mailing Address - Country:US
Mailing Address - Phone:669-252-0521
Mailing Address - Fax:
Practice Address - Street 1:333 W MAUDE AVE STE 110
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94085-4367
Practice Address - Country:US
Practice Address - Phone:669-252-1520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-26
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18599171100000X
171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist