Active NPI
Lauren Gordon-Fahn, L.AC
- Acupuncturist
- Petaluma, CA
National Provider Identifier
1043683360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 16722
- Practice address
- 159 Kentucky St
Suite 10
Petaluma, CA 94952-2305 - Phone
- (707) 774-6595
- NPI assigned
- Nov 9, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 16722 | CA | Primary |
Addresses
Primary practice location
159 Kentucky St
Suite 10
Petaluma, CA 94952-2305
Mailing address
159 Kentucky St
Suite 10
Petaluma, CA 94952-2305
Phone (707) 774-6595
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447027200000",
"number": "1043683360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "159 KENTUCKY ST",
"address_2": "SUITE 10",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949522305",
"telephone_number": "707-774-6595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 KENTUCKY ST",
"address_2": "SUITE 10",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949522305",
"telephone_number": "707-774-6595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON-FAHN",
"first_name": "LAUREN",
"credential": "L.AC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-11-09",
"last_updated": "2015-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "16722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.