Kecia Fowler, DOM
Individual provider Active NPI Acupuncturist · Soquel, CA
NPI 1043680002 · NPPES record last updated Jan 9, 2018
Key facts
- NPI
- 1043680002
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Acupuncturist 171100000X
- License
- AP3866 (FL)
- Practice address
- 3065 Porter St
Suite 105
Soquel, CA 95073-2231 - Phone
- (831) 345-8399
- Fax
- (831) 480-5820
- NPI assigned
- Oct 3, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16733 | CA | MD | Acupuncturist |
| AP3866 | FL | MD | Acupuncturist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 16733 | CA | |
| Acupuncturist | 171100000X | AP3866 | FL | Yes |
Addresses
Primary practice location
3065 Porter St
Suite 105
Soquel, CA 95073-2231
Mailing address
2735 7TH Ave N
St Petersburg, FL 33713-6913
Phone (727) 710-4983
Other providers in Soquel, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.