Healthcare Provider Details

I. General information

NPI: 1700327988
Provider Name (Legal Business Name): JIA XIN HUANG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1975 4TH ST
SAN FRANCISCO CA
94143-2351
US

IV. Provider business mailing address

2516 STOCKTON BLVD
SACRAMENTO CA
95817
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-5153
  • Fax: 415-476-5354
Mailing address:
  • Phone: 916-734-2428
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA158076
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: