Healthcare Provider Details

I. General information

NPI: 1053249573
Provider Name (Legal Business Name): LAURA JU-I YEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA YEN

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16421 REDLANDS LN
HUNTINGTON BEACH CA
92647-4042
US

IV. Provider business mailing address

16421 REDLANDS LN
HUNTINGTON BEACH CA
92647-4042
US

V. Phone/Fax

Practice location:
  • Phone: 714-206-4716
  • Fax:
Mailing address:
  • Phone: 714-206-4716
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: