=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902551500
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AWAKENING ACUPUNCTURE INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/14/2022
-----------------------------------------------------
Last Update Date | 04/07/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2075 FOREST AVE STE 7
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95128-4812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-488-0888
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2075 FOREST AVE STE 7
-----------------------------------------------------
City | SAN JOSE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95128-4812
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-352-5318
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ACUPUNCTURIST
-----------------------------------------------------
Name | YUANYUAN ZHANG
-----------------------------------------------------
Credential | DAOM
-----------------------------------------------------
Telephone | 408-352-5318
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------