# ABUNDANT HEAVEN TRADITIONAL CHINESE MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538568845
- **Authorized official:** JESSICA GIESE-GARDNER L.AC. (DIRECTOR & CO-FOUNDER)
- **Authorized official phone:** (408) 628-1888

## Contact information

- **Practice address:** 621 E CAMPBELL AVE STE 8, CAMPBELL, CA 95008-2126
- **Practice address phone:** (408) 628-1888
- **Practice address fax:** (408) 724-8999
- **Mailing address:** 621 E CAMPBELL AVE STE 8, CAMPBELL, CA 95008-2126
- **Mailing address phone:** (408) 628-1888
- **Mailing address fax:** (408) 724-8999

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | AC 15236 | CA | Yes |

## Other

- **Enumeration date:** 08/22/2014
- **Last updated:** 08/22/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | ZZZ78623Y | BLUE SHIELD OF CALIFORNIA PIN | CA |