Provider Demographics
NPI:1861807307
Name:XIAO, WENNY RENHUI (LAC)
Entity type:Individual
Prefix:
First Name:WENNY
Middle Name:RENHUI
Last Name:XIAO
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1933 VIENTO VERANO DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2707
Mailing Address - Country:US
Mailing Address - Phone:626-768-3540
Mailing Address - Fax:
Practice Address - Street 1:1933 VIENTO VERANO DR
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-2707
Practice Address - Country:US
Practice Address - Phone:626-768-3540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15980171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist