Individual provider Active NPI

Cleo Amelia Tetzloff, LAC

  • Acupuncturist
  • Palm Desert, CA
National Provider Identifier
1073198222
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
19063 Issued in CA
Practice address
73255 El Paseo Ste 8
Palm Desert, CA 92260-4249
Phone
(312) 684-3504
NPI assigned
Mar 9, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 19063 CA Primary

Addresses

Primary practice location

73255 El Paseo Ste 8
Palm Desert, CA 92260-4249

Mailing address

PO Box 43
Palm Desert, CA 92261-0043
Phone (312) 684-3504

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
19063CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1615248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1073198222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 43",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922610043",
            "telephone_number": "312-684-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73255 EL PASEO STE 8",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922604249",
            "telephone_number": "312-684-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TETZLOFF",
        "first_name": "CLEO",
        "middle_name": "AMELIA",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-09",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 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.