Healthcare Provider Details

I. General information

NPI: 1457853061
Provider Name (Legal Business Name): MAI KIA XIONG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2018
Last Update Date: 05/15/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4853 OLIVEHURST AVE
OLIVEHURST CA
95961-4228
US

IV. Provider business mailing address

PO BOX 1520
YUBA CITY CA
95992-1520
US

V. Phone/Fax

Practice location:
  • Phone: 530-749-2746
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: