Individual provider Active NPI

Yenjong Tu

  • Acupuncturist
  • San Jose, CA
National Provider Identifier
1366958548
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC17815 Issued in CA
Practice address
100 Oconnor Dr Ste 27
San Jose, CA 95128-1655
Phone
(669) 269-5080
NPI assigned
Dec 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC17815 CA Primary

Addresses

Primary practice location

100 Oconnor Dr Ste 27
San Jose, CA 95128-1655

Mailing address

PO Box 9312
San Jose, CA 95157-0312
Phone (669) 269-5080

Other names 1

  • Yen Jong Tu Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AC17815CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Azure Pearl Eastern Medicine Acupuncturist CurrentSince Jun 9, 2024 Accepting new patients

Locations

100 Oconnor Dr
Ste 27
San Jose, CA 95128
Phone (408) 287-2225

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1514073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1366958548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9312",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951570312",
            "telephone_number": "669-269-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OCONNOR DR STE 27",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281655",
            "telephone_number": "669-269-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TU",
        "first_name": "YENJONG",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-24",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC17815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "YEN",
            "last_name": "TU",
            "middle_name": "JONG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.