Healthcare Provider Details

I. General information

NPI: 1801574991
Provider Name (Legal Business Name): WHOLE HEALTH SERVICES ACUPUNCTURE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2023
Last Update Date: 07/07/2023
Certification Date: 07/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SHATTUCK AVE STE 2
BERKELEY CA
94709-3401
US

IV. Provider business mailing address

2206 GRANT ST
BERKELEY CA
94703-1714
US

V. Phone/Fax

Practice location:
  • Phone: 510-845-8017
  • Fax: 844-649-0670
Mailing address:
  • Phone: 510-845-8017
  • Fax: 844-649-0670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ABIGAIL SURASKY
Title or Position: PRESIDENT/CEO
Credential: L.AC.
Phone: 510-845-8017