Provider Demographics
NPI:1285772921
Name:CHANG, HUI JU (LAC, PHD)
Entity type:Individual
Prefix:MS
First Name:HUI JU
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:LAC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1580 OAKLAND RD STE C100
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-2441
Mailing Address - Country:US
Mailing Address - Phone:408-682-0929
Mailing Address - Fax:
Practice Address - Street 1:1580 OAKLAND RD STE C100
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-2441
Practice Address - Country:US
Practice Address - Phone:408-682-0929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 10576171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist