Provider Demographics
NPI:1679878250
Name:JOO, SOONHA (ACUPUNCTURIST)
Entity type:Individual
Prefix:DR
First Name:SOONHA
Middle Name:
Last Name:JOO
Suffix:
Gender:F
Credentials:ACUPUNCTURIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10445 FOLSOM BLVD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4610
Mailing Address - Country:US
Mailing Address - Phone:916-386-8754
Mailing Address - Fax:916-386-8754
Practice Address - Street 1:10445 FOLSOM BLVD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-4610
Practice Address - Country:US
Practice Address - Phone:916-386-8754
Practice Address - Fax:916-386-8754
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-13
Last Update Date:2015-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC13846171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAC13846OtherACUPUNCTURE