Provider Demographics
NPI:1386916039
Name:HERRICK, JENNY LIANG (CMT)
Entity type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:LIANG
Last Name:HERRICK
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 MENDOCINO WAY
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94065-1790
Mailing Address - Country:US
Mailing Address - Phone:415-412-2804
Mailing Address - Fax:
Practice Address - Street 1:208 MENDOCINO WAY
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94065-1790
Practice Address - Country:US
Practice Address - Phone:415-412-2804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3891173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist