Individual provider Active NPI

Catherine Mary Kenolio, LAC

  • Acupuncturist
  • San Clemente, CA
National Provider Identifier
1013215508
Registry record updated Mar 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
CA 13517 Issued in CA
Practice address
703 Calle Casita
San Clemente, CA 92673-2708
Phone
(949) 939-6098
NPI assigned
Mar 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X CA 13517 CA Primary

Addresses

Primary practice location

703 Calle Casita
San Clemente, CA 92673-2708

Mailing address

703 Calle Casita
San Clemente, CA 92673-2708

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
CA 13517CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1299456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299456000000",
    "number": "1013215508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 CALLE CASITA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 CALLE CASITA",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732708",
            "telephone_number": "949-939-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENOLIO",
        "first_name": "CATHERINE",
        "middle_name": "MARY",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-07",
        "last_updated": "2011-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "CA 13517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; 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.