Healthcare Provider Details

I. General information

NPI: 1164091070
Provider Name (Legal Business Name): JADE ACUPUNCTURE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2021
Last Update Date: 06/24/2021
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

443 LIGHTHOUSE AVE STE B
MONTEREY CA
93940-1420
US

IV. Provider business mailing address

695 LOBOS ST
MONTEREY CA
93940-2016
US

V. Phone/Fax

Practice location:
  • Phone: 510-935-3071
  • 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: YING LIU
Title or Position: OWNER
Credential:
Phone: 510-935-3071