Jennifer Lynn Randolph, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC16368 Issued in CA

Practice address

1300 W 6TH St Ste 1a
San Pedro, CA 90732-3531

Phone

(310) 833-2557

NPI assigned

Nov 26, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• San Pedro Acupuncture Corporation

  • Acupuncturist
  • San Pedro, CA
  • NPI 1336899020
  NPD Authorized official

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

{
    "created_epoch": "1416960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1013314533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W 6TH ST STE 1A",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323531",
            "telephone_number": "310-833-2557",
            "fax_number": "424-264-5648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W 6TH ST STE 1A",
            "city": "SAN PEDRO",
            "state": "CA",
            "postal_code": "907323531",
            "telephone_number": "310-833-2557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDOLPH",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-26",
        "last_updated": "2021-12-03",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC16368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cora Ramirez Vasquez
• Christina Marie Ramirez
• Jeffrey Ramirez, MD
• Perla Ramirez
• Bertha Alicia Ramos
• Rozanne Nicole Rascon, RN, PHN
• Hillary Jane Rayo, M.L.S.
• Margaret Lentz Reavey
• Ramakrishna T.N. Reddy, M.D.
• Roopa Reddy, M.D.

• Acupuncturist in San Pedro, CA
• Providers in San Pedro, CA by specialty
• Acupuncturist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.