Provider Demographics
NPI:1487419743
Name:HARWOOD, XIAO
Entity type:Individual
Prefix:MRS
First Name:XIAO
Middle Name:
Last Name:HARWOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6200 CRYSTAL SPRINGS CIR
Mailing Address - Street 2:
Mailing Address - City:DISCOVERY BAY
Mailing Address - State:CA
Mailing Address - Zip Code:94505-2629
Mailing Address - Country:US
Mailing Address - Phone:925-393-1418
Mailing Address - Fax:
Practice Address - Street 1:191 SAND CREEK RD STE 230
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-2261
Practice Address - Country:US
Practice Address - Phone:925-393-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-15
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58504225700000X
CAAC19987171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist