Healthcare Provider Details

I. General information

NPI: 1194512939
Provider Name (Legal Business Name): LINLING JIANG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2025
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 W ASHLAN AVE
CLOVIS CA
93612-5625
US

IV. Provider business mailing address

386 W ASHLAN AVE
CLOVIS CA
93612-5625
US

V. Phone/Fax

Practice location:
  • Phone: 415-755-8155
  • Fax:
Mailing address:
  • Phone: 415-755-8155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number220509
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: