Provider Demographics
NPI:1952752768
Name:WANG, HSIANG NI (LAC,MSTCM)
Entity Type:Individual
Prefix:
First Name:HSIANG NI
Middle Name:
Last Name:WANG
Suffix:
Gender:F
Credentials:LAC,MSTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 S DE ANZA BLVD
Mailing Address - Street 2:#104
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4644
Mailing Address - Country:US
Mailing Address - Phone:408-634-3877
Mailing Address - Fax:
Practice Address - Street 1:1340 S DE ANZA BLVD
Practice Address - Street 2:#104
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4644
Practice Address - Country:US
Practice Address - Phone:408-634-3877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16919171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist