Healthcare Provider Details

I. General information

NPI: 1427454933
Provider Name (Legal Business Name): FIRST CHOICE WELLNESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2014
Last Update Date: 01/03/2020
Certification Date: 01/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3680 STEVENS CREEK BLVD STE F
SAN JOSE CA
95117-1205
US

IV. Provider business mailing address

3680 STEVENS CREEK BLVD STE F
SAN JOSE CA
95117-1205
US

V. Phone/Fax

Practice location:
  • Phone: 408-930-1786
  • Fax: 408-260-9963
Mailing address:
  • Phone: 408-930-1786
  • Fax: 408-260-9963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC32832
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC17435
License Number StateCA

VIII. Authorized Official

Name: KATHERINE HEE CHANG
Title or Position: OWNER
Credential:
Phone: 408-930-1786