NPIMap

Organization Active NPI

Kelly Krotine Licensed Acupuncturist

  • Acupuncturist
  • Sherman Oaks, CA
National Provider Identifier
1093076721
Registry record updated May 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
14757 Issued in CA
Legal business name
KELLY KROTINE LICENSED ACUPUNCTURIST
Practice address
4910 Van Nuys Blvd. Suite 104
Sherman Oaks, CA 91403
Phone
(818) 981-3440
Fax
(818) 981-0436
NPI assigned
May 29, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2012

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

Authorized official

Name
Kelly Krotine, L.AC.NPI 1295362630
Title
Chief Executive/Financial Officer
Phone
(818) 981-3440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193400000X SINGLE SPECIALTY GROUP 171100000X 14757 CA Primary

Addresses

Primary practice location

4910 Van Nuys Blvd. Suite 104
Sherman Oaks, CA 91403

Mailing address

4910 Van Nuys Blvd. Suite 104
Sherman Oaks, CA 91403
Phone (818) 981-3440

National Provider Directory

National Provider Directory

Locations

4910 Van Nuys Blvd
Ste 104
Sherman Oaks, CA 91403
Phone (818) 501-8743

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338249600000",
    "number": "1093076721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4910 VAN NUYS BLVD. SUITE 104",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "91403",
            "telephone_number": "818-981-3440",
            "fax_number": "818-981-0436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4910 VAN NUYS BLVD. SUITE 104",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "91403",
            "telephone_number": "818-981-3440",
            "fax_number": "818-981-0436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY KROTINE LICENSED ACUPUNCTURIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-05-29",
        "status": "A",
        "authorized_official_last_name": "KROTINE",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE/FINANCIAL OFFICER",
        "authorized_official_telephone_number": "818-981-3440",
        "authorized_official_credential": "L.AC."
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "14757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherman Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.