Healthcare Provider Details

I. General information

NPI: 1174438394
Provider Name (Legal Business Name): SAGE ACUPUNCTURE & HOLISTIC MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 PARK AVE
MERCED CA
95348-3421
US

IV. Provider business mailing address

130 PARK AVE
MERCED CA
95348-3421
US

V. Phone/Fax

Practice location:
  • Phone: 209-761-7612
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: HANA INGLE
Title or Position: CEO
Credential: LAC
Phone: 831-386-6198