Provider Demographics
NPI:1902275035
Name:HOLLAND-CHANG, STEPHEN (LAC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:HOLLAND-CHANG
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 1:485 ANTELOPE BLVD
Mailing Address - Street 2:SUITE I
Mailing Address - City:RED BLUFF
Mailing Address - State:CA
Mailing Address - Zip Code:96080-2444
Mailing Address - Country:US
Mailing Address - Phone:530-528-2688
Mailing Address - Fax:530-528-2688
Practice Address - Street 1:485 ANTELOPE BLVD
Practice Address - Street 2:SUITE I
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-2444
Practice Address - Country:US
Practice Address - Phone:530-528-2688
Practice Address - Fax:530-528-2688
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-18
Last Update Date:2015-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16710171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist