Healthcare Provider Details

I. General information

NPI: 1023375193
Provider Name (Legal Business Name): XIN HE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2012
Last Update Date: 01/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 COELHO ST
MILPITAS CA
95035-2843
US

IV. Provider business mailing address

1288 KIFER RD STE 202
SUNNYVALE CA
94086-5326
US

V. Phone/Fax

Practice location:
  • Phone: 408-858-8701
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC14793
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: