Healthcare Provider Details

I. General information

NPI: 1134911654
Provider Name (Legal Business Name): JING LIU L.AC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6315 INGLEWOOD DR
PLEASANTON CA
94588-3937
US

IV. Provider business mailing address

6315 INGLEWOOD DR
PLEASANTON CA
94588-3937
US

V. Phone/Fax

Practice location:
  • Phone: 424-209-8820
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: