Healthcare Provider Details

I. General information

NPI: 1952238164
Provider Name (Legal Business Name): NYAH GRACE BLAIS L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 GRAND AVE
OAKLAND CA
94610-2037
US

IV. Provider business mailing address

22150 DELIGHTFUL WAY
REDDING CA
96003-9196
US

V. Phone/Fax

Practice location:
  • Phone: 510-463-4304
  • Fax:
Mailing address:
  • Phone: 530-605-8747
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20583
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: