Healthcare Provider Details

I. General information

NPI: 1023880523
Provider Name (Legal Business Name): OCEANSIDE HEALING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2023
Last Update Date: 10/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PALMETTO AVE SUITE B
PACIFICA CA
94044
US

IV. Provider business mailing address

1301 PALMETTO AVE SUITE B
PACIFICA CA
94044
US

V. Phone/Fax

Practice location:
  • Phone: 650-808-7784
  • Fax:
Mailing address:
  • Phone: 650-808-7784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. JANE KANG
Title or Position: OWNER/MANAGER
Credential: LAC
Phone: 650-808-7784