Provider Demographics
NPI:1740353606
Name:CHEN, JING (ACUPUNCTURIST)
Entity type:Individual
Prefix:
First Name:JING
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18526 VINA DR
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95033
Mailing Address - Country:US
Mailing Address - Phone:408-828-5401
Mailing Address - Fax:408-730-9085
Practice Address - Street 1:2542 SOUTH BASCOM AVE STE 155
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008
Practice Address - Country:US
Practice Address - Phone:408-828-5401
Practice Address - Fax:408-730-9085
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALAC8652171100000X
CAAC8652171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist