Provider Demographics
NPI:1003299157
Name:TRATENG, KAMOLLUCK (LAC)
Entity type:Individual
Prefix:DR
First Name:KAMOLLUCK
Middle Name:
Last Name:TRATENG
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16999 MCGILL RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-9602
Mailing Address - Country:US
Mailing Address - Phone:541-250-2012
Mailing Address - Fax:408-413-1142
Practice Address - Street 1:500 E REMINGTON DR STE 28
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2612
Practice Address - Country:US
Practice Address - Phone:541-250-2012
Practice Address - Fax:408-413-1142
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16450171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist