1699835975 NPI number — MRS. JIANYUN HUANG ENGELHARDT L. AC.

Table of content: MRS. JIANYUN HUANG ENGELHARDT L. AC. (NPI 1699835975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699835975 NPI number — MRS. JIANYUN HUANG ENGELHARDT L. AC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ENGELHARDT
Provider First Name:
JIANYUN
Provider Middle Name:
HUANG
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
L. AC.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699835975
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 KNOWLES DR
Provider Second Line Business Mailing Address:
SUITE 6B
Provider Business Mailing Address City Name:
LOS GATOS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95032-1417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-781-4099
Provider Business Mailing Address Fax Number:
408-866-6890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 KNOWLES DR
Provider Second Line Business Practice Location Address:
SUITE 6B
Provider Business Practice Location Address City Name:
LOS GATOS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95032-1417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-781-4099
Provider Business Practice Location Address Fax Number:
408-866-6890
Provider Enumeration Date:
12/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171100000X , with the licence number:  AC8010 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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