Healthcare Provider Details

I. General information

NPI: 1962367300
Provider Name (Legal Business Name): PROSPEROUS ACUPUNCTURE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4460 BLACK AVE STE C
PLEASANTON CA
94566-6139
US

IV. Provider business mailing address

4460 BLACK AVE STE C
PLEASANTON CA
94566-6139
US

V. Phone/Fax

Practice location:
  • Phone: 408-981-8661
  • Fax:
Mailing address:
  • Phone: 408-981-8661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: LIN CHAI
Title or Position: MANAGER
Credential: CMT
Phone: 408-981-8661