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General NPI Number Information
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NPI Number | 1326394883
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Entity Type | Organization
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Legal Business Name | TERESA T SHEN, PH.D, L.AC, INC, A PROFESSIONAL ACUPUNCTURE CORPORATION
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 3510 OLD SANTA RITA RD SUITE D
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City | PLEASANTON
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State | CA
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Zip | 94588-3466
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Country | US
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Telephone | 925-847-8889
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Fax | 925-847-4180
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Provider Business Mailing Address
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Address Line | 3510 OLD SANTA RITA RD SUITE D
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City | PLEASANTON
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State | CA
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Zip | 94588-3466
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Country | US
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Telephone | 925-847-8889
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Fax | 925-847-4180
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Authorized Official
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Title or Position | CEO/ PRESIDENT
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Name | DR. TERESA SHEN
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Credential | PH.D., L.AC
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Telephone | 925-847-8889
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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 | AC11551
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License Number State | CA
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