Provider Demographics
NPI:1740172998
Name:FENG, OLIVIA XIUJIN (DACM)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:XIUJIN
Last Name:FENG
Suffix:
Gender:F
Credentials:DACM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 GARNET AVE STE 1EF
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3610
Mailing Address - Country:US
Mailing Address - Phone:626-297-6749
Mailing Address - Fax:
Practice Address - Street 1:2180 GARNET AVE STE 1EF
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-3610
Practice Address - Country:US
Practice Address - Phone:626-297-6749
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC20355171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist