Healthcare Provider Details

I. General information

NPI: 1548195142
Provider Name (Legal Business Name): MS. XUANHONG QIU
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18273 HAVEN ST
ASHLAND CA
94541-1433
US

IV. Provider business mailing address

18273 HAVEN ST
ASHLAND CA
94541-1433
US

V. Phone/Fax

Practice location:
  • Phone: 510-520-4073
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number14080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: