Provider Demographics
NPI:1447864517
Name:LIAO, JUIPING (L AC, PHD)
Entity type:Individual
Prefix:DR
First Name:JUIPING
Middle Name:
Last Name:LIAO
Suffix:
Gender:F
Credentials:L AC, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6151 PLYMOUTH AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4737
Mailing Address - Country:US
Mailing Address - Phone:408-579-9139
Mailing Address - Fax:
Practice Address - Street 1:1340 S DE ANZA BLVD STE 104
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4644
Practice Address - Country:US
Practice Address - Phone:408-579-1913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2021-07-12
Deactivation Date:2020-09-09
Deactivation Code:
Reactivation Date:2021-07-12
Provider Licenses
StateLicense IDTaxonomies
CAAC18748171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist