Healthcare Provider Details

I. General information

NPI: 1730867110
Provider Name (Legal Business Name): QIANYING XIE M.A., APCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 MARKET ST
VENTURA CA
93003-7783
US

IV. Provider business mailing address

1033 WYCLIFFE
IRVINE CA
92602-1222
US

V. Phone/Fax

Practice location:
  • Phone: 714-929-1004
  • Fax:
Mailing address:
  • Phone: 626-878-4557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC14050
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: