Provider Demographics
NPI:1316121403
Name:HE, FENG YUN (LAC)
Entity type:Individual
Prefix:
First Name:FENG YUN
Middle Name:
Last Name:HE
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6821 STOCKTON BLVD STE 145
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-2483
Mailing Address - Country:US
Mailing Address - Phone:916-393-2738
Mailing Address - Fax:
Practice Address - Street 1:6821 STOCKTON BLVD STE 145
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-2483
Practice Address - Country:US
Practice Address - Phone:916-393-2738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-25
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 11935171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist