Healthcare Provider Details
I. General information
NPI: 1568205649
Provider Name (Legal Business Name): JJB SPA CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/17/2024
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10835 N WOLFE RD
CUPERTINO CA
95014-0614
US
IV. Provider business mailing address
5183 PARKFIELD AVE
SAN JOSE CA
95129-3227
US
V. Phone/Fax
- Phone: 408-590-1599
- Fax:
- Phone: 408-590-1599
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ZHE
ZHANG
Title or Position: COO AND CO-FOUDER
Credential:
Phone: 408-590-1599