Healthcare Provider Details

I. General information

NPI: 1598629255
Provider Name (Legal Business Name): QIAOSHENG DONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2499 INDUSTRIAL PKWY W
HAYWARD CA
94545-5007
US

IV. Provider business mailing address

1548 137TH AVE
SAN LEANDRO CA
94578-1602
US

V. Phone/Fax

Practice location:
  • Phone: 510-703-9419
  • Fax:
Mailing address:
  • Phone: 510-703-9419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number82859
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: