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General NPI Number Information
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NPI Number | 1861151037
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Entity Type | Organization
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Legal Business Name | VIVIEN'S HOLISTIC ACUPUNCTURE CLINIC INC
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Dates
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Enumeration Date | 12/15/2021
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Last Update Date | 12/15/2021
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Provider Practice Location Address
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Address Line | 2723 CROW CANYON RD STE 211
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City | SAN RAMON
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State | CA
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Zip | 94583-1583
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Country | US
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Telephone | 925-208-1363
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Fax |
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Provider Business Mailing Address
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Address Line | 2723 CROW CANYON RD STE 211
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City | SAN RAMON
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State | CA
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Zip | 94583-1583
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Country | US
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Telephone | 925-208-1363
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ANNIE PAN
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Credential | LAC
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Telephone | 925-639-0207
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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 |
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License Number State |
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