Provider Demographics
NPI:1902549876
Name:AL-SHEHABI, JINAAN
Entity Type:Individual
Prefix:DR
First Name:JINAAN
Middle Name:
Last Name:AL-SHEHABI
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 1:4301 RENAISSANCE DR APT 209
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95134-1564
Mailing Address - Country:US
Mailing Address - Phone:408-677-0402
Mailing Address - Fax:
Practice Address - Street 1:4301 RENAISSANCE DR APT 209
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95134-1564
Practice Address - Country:US
Practice Address - Phone:408-677-0402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-18
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC19396171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist