Individual provider Active NPI

Courtney Blaire Jonson, L.AC.

  • Acupuncturist
  • Portola Valley, CA
National Provider Identifier
1083748784
Registry record updated Mar 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC 10371 Issued in CA
Practice address
884 Portola Road
Suite a-5
Portola Valley, CA 94028-8633
Phone
(650) 346-8732
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X ACU 768 HI
Acupuncturist 171100000X AC 10371 CA Primary

Addresses

Primary practice location

884 Portola Road
Suite a-5
Portola Valley, CA 94028-8633

Mailing address

PO Box 620656
Woodside, CA 94062-0656
Phone (650) 346-8732

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

LicenseStateTypeSpecialty
AC 10371CAMDAcupuncturist
ACU 768HIMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395273600000",
    "number": "1083748784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 620656",
            "city": "WOODSIDE",
            "state": "CA",
            "postal_code": "940620656",
            "telephone_number": "650-346-8732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 PORTOLA ROAD",
            "address_2": "SUITE A-5",
            "city": "PORTOLA VALLEY",
            "state": "CA",
            "postal_code": "940288633",
            "telephone_number": "650-346-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONSON",
        "first_name": "COURTNEY",
        "middle_name": "BLAIRE",
        "credential": "L.AC.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2014-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "HI",
            "license": "ACU 768",
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC 10371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portola Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2014; 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.