Healthcare Provider Details

I. General information

NPI: 1558270694
Provider Name (Legal Business Name): JANE WON DACCHM, L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 RINEHART RD
LADERA RANCH CA
92694-1342
US

IV. Provider business mailing address

PO BOX 2482
MISSION VIEJO CA
92690-0482
US

V. Phone/Fax

Practice location:
  • Phone: 949-424-3683
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20716
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: