Provider Demographics
NPI:1548455165
Name:NIE, WENYING (LAC)
Entity type:Individual
Prefix:
First Name:WENYING
Middle Name:
Last Name:NIE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2100 FOREST AVE SUITE 112
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-4160
Mailing Address - Country:US
Mailing Address - Phone:408-800-3577
Mailing Address - Fax:408-800-3577
Practice Address - Street 1:2100 FOREST AVE SUITE 112
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4160
Practice Address - Country:US
Practice Address - Phone:408-800-3577
Practice Address - Fax:408-800-3577
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAL.AC 5457171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist