Healthcare Provider Details

I. General information

NPI: 1528691417
Provider Name (Legal Business Name): MINDFUL HEALING HEART REIKI & ACUPUNCTURE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 02/19/2020
Certification Date: 02/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 E FOOTHILL BLVD
PASADENA CA
91107-3463
US

IV. Provider business mailing address

2801 E FOOTHILL BLVD
PASADENA CA
91107-3463
US

V. Phone/Fax

Practice location:
  • Phone: 626-642-8993
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: WINNIE CHAN WANG
Title or Position: CEO
Credential: LAC
Phone: 626-642-8993