Individual provider Active NPI

Jessie Rei Yamasaki-Sanders, L.AC., DATM

  • Acupuncturist
  • Los Angeles, CA
National Provider Identifier
1184442907
Registry record updated Jan 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
AC20188 Issued in CA
Practice address
2945 Rowena Ave
Los Angeles, CA 90039-2003
Phone
(323) 522-3822
NPI assigned
Oct 1, 2024
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC20188 CA Primary

Addresses

Primary practice location

2945 Rowena Ave
Los Angeles, CA 90039-2003

Mailing address

4856 Round Top Dr
Los Angeles, CA 90065-5230
Phone (704) 941-9440

Other practice location 1

440 Shatto Pl
Los Angeles, CA 90020-1793
Phone (213) 487-0150

Other names 1

  • Jessica Rei Vandenberg Former name

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
AC20188CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosalind Bullard Acupuncture Inc. PastSince Oct 6, 2024 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": "1727740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737504000000",
    "number": "1184442907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 ROUND TOP DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900655230",
            "telephone_number": "704-941-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2945 ROWENA AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900392003",
            "telephone_number": "323-522-3822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "440 Shatto Pl",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900201793",
            "country_code": "US",
            "telephone_number": "213-487-0150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAMASAKI-SANDERS",
        "first_name": "JESSIE",
        "middle_name": "REI",
        "name_prefix": "Dr.",
        "credential": "L.AC., DATM",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2024-10-01",
        "last_updated": "2025-01-22",
        "certification_date": "2025-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "CA",
            "license": "AC20188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "VANDENBERG",
            "middle_name": "REI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2025; 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.