Healthcare Provider Details

I. General information

NPI: 1306867445
Provider Name (Legal Business Name): NORTHERN CALIFORNIA HEALTH AND ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 CASTRO ST SUITE A
MOUNTAIN VIEW CA
94041-1205
US

IV. Provider business mailing address

PO BOX 391510
MOUNTAIN VIEW CA
94039-1510
US

V. Phone/Fax

Practice location:
  • Phone: 650-320-0008
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 4327
License Number StateCA

VIII. Authorized Official

Name: DR. JENNY SHI
Title or Position: PRESIDENT
Credential: L.AC.
Phone: 650-320-0008