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General NPI Number Information
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NPI Number | 1265241871
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Entity Type | Individual
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Provider Name | KIM HOANG JENSEN D.A.C.M., LA.C
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Gender | Female
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 01/07/2025
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Provider Practice Location Address
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Address Line | 815 GRAND AVENUE SUITE 105
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City | SAN MARCOS
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State | CA
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Zip | 92078
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Country | US
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Telephone | 760-891-8083
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Fax |
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Provider Business Mailing Address
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Address Line | 2035 CHEROKEE LANE
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City | ESCONDIDO
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State | CA
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Zip | 92026-1700
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC20199
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License Number State | CA
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