Individual provider Active NPI

Elaine Sta-Iglesia, LAC

  • Acupuncturist
  • Pacifica, CA
National Provider Identifier
1134701477
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
19075 Issued in CA
Practice address
1009 Terra Nova Blvd
Pacifica, CA 94044-4308
Phone
(650) 440-6647
NPI assigned
Apr 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 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 19075 CA Primary

Addresses

Primary practice location

1009 Terra Nova Blvd
Pacifica, CA 94044-4308

Mailing address

208 Avalon Dr
Daly City, CA 94015-4601
Phone (415) 203-0590

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
19075CAMDAcupuncturist

NPI Registry JSON

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1134701477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 AVALON DR",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940154601",
            "telephone_number": "415-203-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 TERRA NOVA BLVD",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940444308",
            "telephone_number": "650-440-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STA-IGLESIA",
        "first_name": "ELAINE",
        "credential": "LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-26",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "19075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pacifica, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.