Healthcare Provider Details

I. General information

NPI: 1225623747
Provider Name (Legal Business Name): PEMA ACUPUNCTURE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2021
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

542 LAKESIDE DR STE 5
SUNNYVALE CA
94085-4005
US

IV. Provider business mailing address

1611 ELWOOD DR
LOS GATOS CA
95032-1033
US

V. Phone/Fax

Practice location:
  • Phone: 510-673-7789
  • Fax:
Mailing address:
  • Phone: 510-673-7789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: JULIANA FANG
Title or Position: ACUPUNCTURIST
Credential: L.AC
Phone: 510-673-7789