Active NPI
Natasha Khallouf, LA.C
- Acupuncturist
- Sebastopol, CA
National Provider Identifier
1154675981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Acupuncturist
- License
- 15072
- Practice address
- 490 Pitt Ave
Sebastopol, CA 95472-3747 - Phone
- (707) 495-2317
- NPI assigned
- Oct 31, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist | 171100000X | 15072 | CA | Primary |
Addresses
Primary practice location
490 Pitt Ave
Sebastopol, CA 95472-3747
Mailing address
PO Box 536
Sebastopol, CA 95473-0536
Phone (707) 495-2317
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15072 | CA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1351641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1434240000000",
"number": "1154675981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 536",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954730536",
"telephone_number": "707-495-2317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "490 PITT AVE",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954723747",
"telephone_number": "707-495-2317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALLOUF",
"first_name": "NATASHA",
"credential": "LA.C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-10-31",
"last_updated": "2015-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "171100000X",
"taxonomy_group": "",
"desc": "Acupuncturist",
"state": "CA",
"license": "15072",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sebastopol, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.