Healthcare Provider Details

I. General information

NPI: 1487419743
Provider Name (Legal Business Name): MRS. XIAO HARWOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2024
Last Update Date: 09/09/2024
Certification Date: 09/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 SAND CREEK RD STE 230
BRENTWOOD CA
94513-2261
US

IV. Provider business mailing address

6200 CRYSTAL SPRINGS CIR
DISCOVERY BAY CA
94505-2629
US

V. Phone/Fax

Practice location:
  • Phone: 925-393-1418
  • Fax:
Mailing address:
  • Phone: 925-393-1418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC19987
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number58504
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: