Healthcare Provider Details

I. General information

NPI: 1427877620
Provider Name (Legal Business Name): ZHEN TIAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2024
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 MORGAN ST
SANTA ROSA CA
95401-5129
US

IV. Provider business mailing address

1112 MORGAN ST
SANTA ROSA CA
95401-5129
US

V. Phone/Fax

Practice location:
  • Phone: 707-799-4016
  • Fax:
Mailing address:
  • Phone: 707-799-4016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC20748
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number25775
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: