Healthcare Provider Details

I. General information

NPI: 1538095476
Provider Name (Legal Business Name): RUI YANG L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2040 FOREST AVE STE 4
SAN JOSE CA
95128-4800
US

IV. Provider business mailing address

PO BOX 882
SAN JOSE CA
95002-0882
US

V. Phone/Fax

Practice location:
  • Phone: 408-823-5663
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number20682
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: