Melanie Fuller, L.AC.

Individual provider Active NPI Acupuncturist · Boonville, CA

NPI 1194169508 · NPPES record last updated Oct 4, 2022

Key facts

NPI
1194169508
Entity type
Individual (NPI type 1)
Primary specialty
Acupuncturist 171100000X
License
AC15056 (CA)
Practice address
13500 Airport Rd
Boonville, CA 95415-9133
Phone
(707) 895-3477
Fax
(707) 895-2035
NPI assigned
Apr 29, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
AC15056CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Anderson Valley Health Center Current
since Oct 9, 2022
Accepting new patients
Anderson Valley Ambulance Service Past
since Oct 9, 2022
Accepting new patients
Sutter Bay Hospitals Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BICHAA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X AC15056 CA Yes

Addresses

Primary practice location

13500 Airport Rd
Boonville, CA 95415-9133

Mailing address

PO Box 338
Boonville, CA 95415-0338
Phone (707) 895-3477

Other providers in Boonville, CA

All providers in Boonville, CA · Acupuncturist in California

Sources for this page

Verify at the official NPI Registry.