Provider Demographics
NPI:1194152975
Name:CHEN, XIUYAN (LAC)
Entity type:Individual
Prefix:MS
First Name:XIUYAN
Middle Name:
Last Name:CHEN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E CALAVERAS BLVD
Mailing Address - Street 2:SUITE# 349
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7703
Mailing Address - Country:US
Mailing Address - Phone:408-946-8918
Mailing Address - Fax:
Practice Address - Street 1:500 E CALAVERAS BLVD
Practice Address - Street 2:SUITE # 349
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7703
Practice Address - Country:US
Practice Address - Phone:916-273-2552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-11
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15718171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist