Healthcare Provider Details

I. General information

NPI: 1083570600
Provider Name (Legal Business Name): WENQIANG WU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2025
Last Update Date: 12/29/2025
Certification Date: 12/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 9TH ST APT A
ALAMEDA CA
94501-3410
US

IV. Provider business mailing address

1408 9TH ST
ALAMEDA CA
94501-3410
US

V. Phone/Fax

Practice location:
  • Phone: 510-350-6052
  • Fax:
Mailing address:
  • Phone: 510-350-6052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number93278
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: