Healthcare Provider Details

I. General information

NPI: 1750753950
Provider Name (Legal Business Name): VIOLA HUANG-BECK L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2015
Last Update Date: 10/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3637 MONTGOMERY DR
SANTA ROSA CA
95405-5212
US

IV. Provider business mailing address

3637 MONTGOMERY DR
SANTA ROSA CA
95405-5212
US

V. Phone/Fax

Practice location:
  • Phone: 707-360-8176
  • Fax: 707-546-1689
Mailing address:
  • Phone: 707-360-8176
  • Fax: 707-546-1689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC7593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: