Individual provider Active NPI

Jessica Shy Chen, L.AC., DILP. O.M.

  • Acupuncturist
  • Santa Monica, CA
National Provider Identifier
1104963396
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
10684 Issued in CA
Practice address
1131 Wilshire Blvd
Suite 300
Santa Monica, CA 90401-2061
Phone
(310) 917-2200
Fax
(310) 917-2204
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X 10684 CA Primary

Addresses

Primary practice location

1131 Wilshire Blvd
Suite 300
Santa Monica, CA 90401-2061

Mailing address

3703 Inglewood Blvd
Apt. 204
Los Angeles, CA 90066-3200
Phone (310) 572-7871

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

Practice roles

OrganizationSpecialtyStatusNew patients
Myqi Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104963396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3703 INGLEWOOD BLVD",
            "address_2": "APT. 204",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900663200",
            "telephone_number": "310-572-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1131 WILSHIRE BLVD",
            "address_2": "SUITE 300",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012061",
            "telephone_number": "310-917-2200",
            "fax_number": "310-917-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHEN",
        "first_name": "JESSICA",
        "middle_name": "SHY",
        "credential": "L.AC., DILP. O.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "10684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.