Healthcare Provider Details

I. General information

NPI: 1699586792
Provider Name (Legal Business Name): ROAD TO WELLNESS ACUPUNCTURE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 02/18/2025
Certification Date: 02/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4121 WESTERLY PL STE 113
NEWPORT BEACH CA
92660-2331
US

IV. Provider business mailing address

22431 ANTONIO PKWY # B160-639
RANCHO SANTA MARGARITA CA
92688-2804
US

V. Phone/Fax

Practice location:
  • Phone: 657-205-7163
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. AMY H TRUONG
Title or Position: CEO/OWNER
Credential: DTCM, MPH
Phone: 657-205-7163