Active NPI
Gina Negri Klebanoff, LAC, DIPL OM
- Acupuncturist
- Laguna Beach, CA
National Provider Identifier
1053649129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- AC13274
- Practice address
- 964 Meadowlark Dr
Laguna Beach, CA 92651-2806 - Phone
- (949) 280-6676
- NPI assigned
- Nov 30, 2009
- Sex
- Female
- Sole proprietor
- No
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 | AC13274 | CA | Primary |
Addresses
Primary practice location
964 Meadowlark Dr
Laguna Beach, CA 92651-2806
Mailing address
964 Meadowlark Dr
Laguna Beach, CA 92651-2806
Phone (949) 280-6676
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
| License | State | Type | Specialty |
|---|---|---|---|
| AC13274 | CA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1259539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304899200000",
"number": "1053649129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "964 MEADOWLARK DR",
"city": "LAGUNA BEACH",
"state": "CA",
"postal_code": "926512806",
"telephone_number": "949-280-6676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "964 MEADOWLARK DR",
"city": "LAGUNA BEACH",
"state": "CA",
"postal_code": "926512806",
"telephone_number": "949-280-6676"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEBANOFF",
"first_name": "GINA",
"middle_name": "NEGRI",
"credential": "LAC, DIPL OM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-30",
"last_updated": "2011-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "AC13274",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laguna Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.